• 제목/요약/키워드: Acceptable risk

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욕창, 낙상예방 및 통증간호의 간호과정 적용 평가도구 개발 (Development of Performance Measures Based on the Nursing Process for Prevention and Management of Pressure Ulcers, Falls and Pain)

  • 김금순;김진아;김문숙;김유정;김을순;박광옥;송말순;이영희;이인옥;정연이;최윤경
    • 임상간호연구
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    • 제15권1호
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    • pp.133-147
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    • 2009
  • Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

Persistence and Degradation Pattern of Acequinocyl and Its Metabolite, Hydroxyl-Acequinocyl and Fenpyroximate in Butterburs (Petasites japonicus Max.)

  • Leesun Kim;Geun-Hyoung Choi;Hyun Ho Noh;Hee-Dong Lee;Hak-won Lee;Kee Sung Kyung;Jin-Ho Ro
    • 한국환경농학회지
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    • 제42권2호
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    • pp.93-103
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    • 2023
  • Persistence and degradation patterns of acequinocyl and its metabolite, hydroxyl-acequinocyl (acequinocyl-OH) and fenpyroximate in butterburs (Petasites japonicus Max.) were investigated after pesticide application. Butterburs, one of the minor crops in South Korea, was planted in two plots (plot A for double and plot B for single application) in a greenhouse. Butterburs samples were also planted in a separate plot without pesticide treatment, as the control. A commercial pesticide containing acequinocyl and fenpyroximate was applied to the foliage of butterburs at hourly intervals after dilution. Recoveries of acequinocyl and acequinocyl-OH were 78.6-84.7% and 83.7-95.5%, respectively; the relative standard deviation of the two compounds were less than 5%. The method limit of quantification was 0.01 mg/kg. The total (Ʃ) acequinocyl residues in butterburs reduced by 96.0% at 14 days and 75.9% at 7 days, in plot A and B, respectively, after final pesticide applications. The biological half-life (DT50) of Ʃ acequinocyl and fenpyroximate, calculated using the dissipation rate, was 3.0 days and 4.0 days, respectively. These data were used to set up maximum residue and safe standard levels when the pesticides are applied to control pests during butterbur cultivation. Risk assessment results showed that the maximum % acceptable daily intake was 7.74% for Ʃ acequinocyl and 0.16% for Ʃ fenpyroximate. The theoretical maximum daily intake of Ʃ acequinocyl and fenpyroximate was 26.3% and 35.8%, respectively. In conclusion, the concentrations of Ʃ acequinocyl and fenpyroximate in butterburs pose no significant health risks to Koreans.

Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study

  • George Samanidis;Konstantinos Kostopanagiotou;Meletios Kanakis;Georgios Kourelis;Kyriaki Kolovou;Georgios Vagenakis;Dimitrios Bobos;Nicholas Giannopoulos
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.187-192
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    • 2023
  • Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

국내 OTT 사업자의 해외시장 진출의 사업성 연구 : 현금흐름 추정에 의한 시나리오 분석을 중심으로 (A Study on the Business of the Korean OTT in North American Market : Focusing on scenario analysis based on cash flow estimation)

  • 변상규;박천일;위경우
    • 한국콘텐츠학회논문지
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    • 제22권8호
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    • pp.274-287
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    • 2022
  • OTT 서비스가 확산되면서 방송 시장에서 경쟁이 심화되고 있다. 콘텐츠 경쟁력이 높은 우리나라는 국제적인 콘텐츠 공급기지가 되고 있다. 이는 국내 콘텐츠 제작업계에게는 도움이 되겠지만, 결국 글로벌 영상산업구조에서 하청으로 편입되는 결과를 초래한다. 그러므로 한국계 OTT 사업자들이 해외진출을 통해 시장을 넓히고, 콘텐츠 경쟁력을 수익 확대로 연결하여 경쟁력을 유지할 필요가 있다. 본 연구는 국내 OTT 사업자의 해외사업에 대하여 사업성을 분석하여 위험도를 줄이고 참고자료를 제공하고자 수행되었다. 전문가 심층인터뷰와 문헌검토를 통해 북미시장을 성공 잠재력이 높은 지역으로 선정하였고, 현지 플랫폼 사업자와의 제휴를 통한 진출이 유효함을 확인하였다. 그리고 매출과 투입비용을 추정하고, 순현재가치법으로 사업성을 평가하였다. 판권비용, 가입자 수, 요금에 대해서는 복수의 추정치를 이용하여 총 18개의 시나리오를 만들었다. 분석결과 8개의 시나리오가 채택 가능한 것으로 나타났다. 그리고 판권비용이 사업성에 가장 큰 영향을 미치며, 요금, 가입자의 순으로 확인되었다.

Mechanical properties of sustainable green self-compacting concrete incorporating recycled waste PET: A state-of-the-art review

  • Shireen T. Saadullah;James H. Haido;Yaman S.S. Al-Kamaki
    • Advances in concrete construction
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    • 제16권1호
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    • pp.35-57
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    • 2023
  • Majority of the plastic produced each year is being disposed in land after single-use, which becomes waste and takes up a lot of storage space. Therefore, there is an urgent need to find alternative solutions instead of disposal. Recycling and reusing the PET plastic waste as aggregate replacement and fiber in concrete production can be one of the eco- friendly methods as there is a great demand for concrete around the world, especially in developing countries by raising human awareness of the environment, the economy, and Carbon dioxide (CO2) emissions. Self-compacting concrete (SCC) is a key development in concrete technology that offers a number of attractive features over traditional concrete applications. Recently, in order to improve its durability and prevent such plastics from directly contacting the environment, various kinds of plastics have been added. This review article summarizes the latest evident on the performance of SCC containing recycled PET as eco-friendly aggregates and fiber. Moreover, it highlights the influence of substitution content, shape, length, and size on the fresh and properties of SCC incorporating PET plastic. Based on the findings of the articles that were reviewed for this study, it is observed that SCC made of PET plastic (PETSCC) can be employed in construction era owing to its acceptable mechanical and fresh properties. On the other hand, it is concluded that owing to the lightweight nature of plastic aggregate, Reusing PET waste in the construction application is an effective approach to reduces the earthquake risk of a building.

The cumulative survival rate of sandblasted, large-grit, acid-etched dental implants: a retrospective analysis

  • Haeji Yum;Hee-seung Han;Kitae Kim;Sungtae Kim;Young-Dan Cho
    • Journal of Periodontal and Implant Science
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    • 제54권2호
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    • pp.122-135
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    • 2024
  • Purpose: This retrospective study aimed to assess the long-term cumulative survival rate of titanium, sandblasted, large-grit, acid-etched implants over a 10-year follow-up period and investigate the factors affecting the survival rate and change in marginal bone loss (MBL). Methods: The study included 400 patients who underwent dental implant placement at the Department of Periodontology of Seoul National University Dental Hospital (SNUDH) between 2005 and 2015. Panoramic radiographic images and dental records of patients were collected and examined using Kaplan-Meier analysis, Cox proportional hazards regression analysis, and multiple regression analysis to determine the survival rates and identify any factors related to implant failure and MBL. Results: A total of 782 implants were placed with a follow-up period ranging from 0 to 16 years (mean: 8.21±3.75 years). Overall, 25 implants were lost, resulting in a cumulative survival rate of 96.8%. Comparisons of the research variables regarding cumulative survival rate mostly yielded insignificant results. The mean mesial and distal MBLs were 1.85±2.31 mm and 1.59±2.03 mm, respectively. Factors influencing these values included age, diabetes mellitus (DM), jaw location, implant diameter, bone augmentation surgery, and prosthetic unit. Conclusions: This study found that the implant survival rates at SNUDH fell within the acceptable published criteria. The patients' sex, age, DM status, implant location, implant design, implant size, surgical type, bone augmentation, and prosthetic unit had no discernible influence on long-term implant survival. Sandblasted, large-grit, acid-etched implants might offer advantages in terms of implant longevity and consistent clinical outcomes.

Open Reduction and Internal Fixation for Vancouver B1 and B2 Periprosthetic Femoral Fractures: A Proportional Meta-Analysis

  • Byung-Ho Yoon;Seong Gyun Park;Young Hak Roh
    • Hip & pelvis
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    • 제35권4호
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    • pp.217-227
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    • 2023
  • Purpose: Periprosthetic femoral fracture (PFF) is a common complication after total hip arthroplasty, and open reduction and internal fixation (ORIF) is a common surgical treatment. We conducted a meta-analysis to compare the outcomes of ORIF in patients with different fracture patterns (Vancouver B1 and B2). Materials and Methods: We conducted a systematic search of PubMed, Embase, Cochrane Library and KoreaMed from inception to August 2022. We conducted a pair-wise meta-analysis (with a fixed-effects model) on the 10 comparative studies and a proportional meta-analysis on the data from the 39 articles to determine a consensus. The outcomes were the incidence of reoperations that included osteosynthesis, irrigation/debridement and revision arthroplasty. Results: The pair-wise meta-analysis showed similar outcomes between two groups; the risk of reoperation (odds ratio [OR]=0.82, confidence interval [CI] 0.43-1.55, P=0.542), nonunion (OR=0.49; CI 0.22-1.10, P=0.085) and deep infection (OR=1.89, CI 0.48-7.46, P=0.361). In proportion meta-analysis, pooled prevalence of reoperation was 9% (95% CI, 6-12) in B1 and 8% (95% CI, 2-15) in B2 (heterogeneity between two groups (Q), P=0.772). The pooled prevalence of nonunion was same as of 4% in B1 and B2 (Q, P=0.678), and deep infection was 2% (95% CI, 1-3) in B1 and 4% (95% CI, 2-7) in B2 (Q, P=0.130). Conclusion: ORIF is a feasible treatment for B1 and B2 periprosthetic femoral fractures, with acceptable outcomes in terms of, nonunion and infection. The results of this study would help clinicians and provide baseline data for further studies validating PFF.

Outcomes of liver transplantation for hepatocellular carcinoma: Experiences from a Vietnamese center

  • Khai Viet Ninh;Dang Hai Do;Trung Duc Nguyen;Phuong Ha Tran;Tuan Hoang;Dung Thanh Le;Nghia Quang Nguyen
    • 한국간담췌외과학회지
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    • 제28권1호
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    • pp.34-41
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    • 2024
  • Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.

저체온하 순환정지를 이용한 소아 개심술 후의 신경계 이상에 대한 펑가 (Evaluation of Neurologic Abnormalities After Deep Hypothermic Circulatory Arrest for Pediatric Cardiac Surgery)

  • 박계현;전태국;지현근;이정렬;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • 제29권1호
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    • pp.14-23
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    • 1996
  • Circulatory arrest under deep hypothermia is an important auxiliary means for cardiac surgery, especially useful in pediatric patients. However, its clinical safety, particularly with regard to the neurologic outcome after long duration of circulatory arrest, is still not established. This study is a review of the eight years'clinical experience of hypothermic circulatory arrest at the Seoul national University Children's Hospital. During an eight-year period from January 1986 through December 1993, a total of 589 consecutive cardiac operations were done using circulatory arrest under deep hypothermia. Among them, 434 consecutive patients, in whom the duration of arrest was 20 minutes or more, are the subject of this study. The duration of arrest ranged from 20 minutes to 82 minutes (mean = 38.7 minutes) under rectal temperature in the range from 12.5$^{\circ}C$ to 25.8$^{\circ}C$. Early neurologic abnormalities occurred in 47 patients : seizure attacks in 28 patients, motor paralyses with or w thout seizure in 12, blindness in 2, and no recovery of consciousness in 5 patients. The rate of incidence of early neurologic abnormalities was calculated at 15.7%. 25 patients showed late neuropsychologic sequelae, such as motor paralysis (9 patients), recurrent seizures (6), developmental delay (8), and definitely low intelligence (2). The rate of incidence of late neurologic sequelae was 8.5%, By statistical analysis, the following factors were identified as the risk factors for post-arrest neurologic abnormalities ; 1) long duration of circulatory arrest, 2) lower-than-ideal body weight, 3) preexisting neurological abnormalities, 4) associated non-cardiovascular congenital anouialies, and 5) low blood pressure during the early post-arrest period. It is concluded that circulatory arrest under deep hypothermia is a relatively safe means for pediatric cardiac surgery with acceptable risk. However, to warrant maximal safety, it is desirable to limit the duration of arrest to less th n 40 minutes. In addition, it is our contention that the early post-arrest period is a very critical period during which maintenance of adequate perfusion pressure in important for the neurologic outcome.

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Risk of Treatment Related Death and Febrile Neutropaenia with First Line Palliative Chemotherapy for De Novo Metastatic Breast Cancer in Clinical Practice in a Middle Resource Country

  • Phua, Chee Ee;Tang, Weng Heng;Yusof, Mastura Md.;Saad, Marniza;Alip, Adlinda;See, Mee Hoong;Taib, Nur Aishah
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10263-10266
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    • 2015
  • Background: The risk of febrile neutropaenia (FN) and treatment related death (TRD) with first line palliative chemotherapy for de novo metastatic breast cancer (MBC) remains unknown outside of a clinical trial setting despite its widespread usage. This study aimed to determine rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: Patients who were treated with first line palliative chemotherapy for de novo MBC from 2002-2011 in UMMC were identified from the UMMC Breast Cancer Registry. Information collected included patient demographics, histopathological features, treatment received, including the different chemotherapy regimens, and presence of FN and TRD. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al, 2010). TRD was defined as death occurring during or within 30 days of the last chemotherapy treatment, as a consequence of the chemotherapy treatment. Statistical analysis was performed using the SPSS version 18.0 software. Survival probabilities were estimated using the Kaplan-Meier method and differences in survival compared using log-rank test. Results: Between $1^{st}$ January 2002 and $31^{st}$ December 2011, 424 patients with MBC were treated in UMMC. A total of 186 out of 221 patients with de novo MBC who received first line palliative chemotherapy were analyzed. The mean age of patients in this study was 49.5 years (range 24 to 74 years). Biologically, ER status was negative in 54.4% of patients and Her-2 status was positive in 31.1%. A 5-flourouracil, epirubicin and cyclophosphamide (FEC) chemotherapy regimen was chosen for 86.6% of the cases. Most patients had multiple metastatic sites (58.6%). The main result of this study showed a FN rate of 5.9% and TRD rate of 3.2%. The median survival (MS) for the entire cohort was 19 months. For those with multiple metastatic sites, liver only, lung only, bone only and brain only metastatic sites, the MS was 18, 24, 19, 24 and 8 months respectively (p-value= 0.319). Conclusions: In conclusion, we surmise that FEC is a safe regimen with acceptable FN and TRD rates for de novo MBC.