• Title/Summary/Keyword: Appropriate Risk Standard

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Incidence and Risk Factors for Extended-Spectrum ${\beta}-Lactamase-Producing$ Escherichia coli in Community-acquired Childhood Urinary Tract Infection (지역사회 획득 소아 요로 감염에서 Extended-Spectrum ${\beta}-Lactamase$ 생성)

  • Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.214-222
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    • 2004
  • Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

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Corporate Bond Rating Using Various Multiclass Support Vector Machines (다양한 다분류 SVM을 적용한 기업채권평가)

  • Ahn, Hyun-Chul;Kim, Kyoung-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.157-178
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    • 2009
  • Corporate credit rating is a very important factor in the market for corporate debt. Information concerning corporate operations is often disseminated to market participants through the changes in credit ratings that are published by professional rating agencies, such as Standard and Poor's (S&P) and Moody's Investor Service. Since these agencies generally require a large fee for the service, and the periodically provided ratings sometimes do not reflect the default risk of the company at the time, it may be advantageous for bond-market participants to be able to classify credit ratings before the agencies actually publish them. As a result, it is very important for companies (especially, financial companies) to develop a proper model of credit rating. From a technical perspective, the credit rating constitutes a typical, multiclass, classification problem because rating agencies generally have ten or more categories of ratings. For example, S&P's ratings range from AAA for the highest-quality bonds to D for the lowest-quality bonds. The professional rating agencies emphasize the importance of analysts' subjective judgments in the determination of credit ratings. However, in practice, a mathematical model that uses the financial variables of companies plays an important role in determining credit ratings, since it is convenient to apply and cost efficient. These financial variables include the ratios that represent a company's leverage status, liquidity status, and profitability status. Several statistical and artificial intelligence (AI) techniques have been applied as tools for predicting credit ratings. Among them, artificial neural networks are most prevalent in the area of finance because of their broad applicability to many business problems and their preeminent ability to adapt. However, artificial neural networks also have many defects, including the difficulty in determining the values of the control parameters and the number of processing elements in the layer as well as the risk of over-fitting. Of late, because of their robustness and high accuracy, support vector machines (SVMs) have become popular as a solution for problems with generating accurate prediction. An SVM's solution may be globally optimal because SVMs seek to minimize structural risk. On the other hand, artificial neural network models may tend to find locally optimal solutions because they seek to minimize empirical risk. In addition, no parameters need to be tuned in SVMs, barring the upper bound for non-separable cases in linear SVMs. Since SVMs were originally devised for binary classification, however they are not intrinsically geared for multiclass classifications as in credit ratings. Thus, researchers have tried to extend the original SVM to multiclass classification. Hitherto, a variety of techniques to extend standard SVMs to multiclass SVMs (MSVMs) has been proposed in the literature Only a few types of MSVM are, however, tested using prior studies that apply MSVMs to credit ratings studies. In this study, we examined six different techniques of MSVMs: (1) One-Against-One, (2) One-Against-AIL (3) DAGSVM, (4) ECOC, (5) Method of Weston and Watkins, and (6) Method of Crammer and Singer. In addition, we examined the prediction accuracy of some modified version of conventional MSVM techniques. To find the most appropriate technique of MSVMs for corporate bond rating, we applied all the techniques of MSVMs to a real-world case of credit rating in Korea. The best application is in corporate bond rating, which is the most frequently studied area of credit rating for specific debt issues or other financial obligations. For our study the research data were collected from National Information and Credit Evaluation, Inc., a major bond-rating company in Korea. The data set is comprised of the bond-ratings for the year 2002 and various financial variables for 1,295 companies from the manufacturing industry in Korea. We compared the results of these techniques with one another, and with those of traditional methods for credit ratings, such as multiple discriminant analysis (MDA), multinomial logistic regression (MLOGIT), and artificial neural networks (ANNs). As a result, we found that DAGSVM with an ordered list was the best approach for the prediction of bond rating. In addition, we found that the modified version of ECOC approach can yield higher prediction accuracy for the cases showing clear patterns.

Food Protein-induced Enterocolitis Syndrome: an Update on Clinical Approaches and Its Pathophysiology (식품 단백질 유발성 장염 증후군: 임상적 접근과 병태생리의 최신 지견)

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.117-128
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    • 2007
  • Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.

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A Review of Renal Dialysis Unit Environment for Infection Prevention - Focused on Evidence Based Design (감염 예방을 위한 인공신장실 의료 환경에 대한 고찰 - 근거 기반의 디자인 중심으로)

  • Han, Su Ha;Yoon, Hyungjin
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.49-57
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    • 2018
  • Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.

Time-Temperature Curve for Fire Safety Assessment of Metropolitan Transit Tunnels (도시철도 터널구조체의 내화안정성 평가를 위한 표준시간-온도곡선 적용)

  • Won, Jong-Pil;Choi, Min-Jung;Lee, Su-Jin;Lee, Sang-Woo
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.14 no.3
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    • pp.118-122
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    • 2010
  • The study presents a standard time-temperature curve to evaluate the fire performance of subway tunnel structures. The central subway section is 135km long in Korea, the fourth longest in the world. The number of subway tunnels has been increasing rapidly and fire risk is proportional to the tunnel length. However, an adequate time-temperature curve for subway tunnel fires does not exist. Therefore, we studied a proposed foreign fire design model for which the heat rate is based on the traffic, and we present an appropriate time-temperature curve for Korean subway tunnels. The ISO 834 curve was used as a fire design model and the temperature distribution in the tunnel was estimated using numerical analysis. This led to a proposal for effective measures against subway tunnel fires.

Consideration of Cut-off Value for Fibrosis Serum Marker by Liver Fibrosis Stage in Chronic Hepatitis C Patients (만성 C형간염 환자에서 간섬유화 등급별 혈청표지자들의 Cut-off값에 대한 고찰)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.539-546
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    • 2019
  • Liver biopsy is invasive and it is a risk of complications. Nevertheless, liver biopsy is gold standard for predicting liver fibrosis. To compensate for these shortcomings, in this study, the liver fibrosis stage was divided using Fibroscan(R) in 200 chronic hepatitis C patients. And, the usefulness and cut-off values of fibrosis index based on four factors(FIB-4), AST to platelet ratio index(APRI) and AST/ALT ratio(AAR) calculated as serum tests were investigated by analyzing ROC curve. As a result, using FIB-4 and APRI rather than AAR is appropriate for evaluation of liver fibrosis. And using APRI to predict significant Fibrosis(F2) and FIB-4 is considered useful for predicting cirrhosis(F4). By applying the advantages of the serum based liver fibrosis marker, which are convenient and repeatable, liver fibrosis follow-up term can be reduced, and furthermore, the prevalence of liver cirrhosis and hepatocellular carcinoma(HCC) can be reduced.

Analysis of the Domestic Construction Industry Classification System through an Overseas Construction Industry Case Study (해외 건설산업의 사례에 의한 국내 건설 업종 분류체계의 비교 분석)

  • Kim, Jeong-wook;Kim, Gyu-yong;Choi, Min-soo;Nam, Jeong-soo;Lee, Sang-soo
    • Journal of the Korea Institute of Building Construction
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    • v.22 no.5
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    • pp.463-471
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    • 2022
  • The construction industry has a structure in which information asymmetry problems are complexly scattered compared to other industries. Since the construction industry classification system serves as a guideline for entering the construction market and can provide as a standard for construction consumers to select a supplier who can provide appropriate services, when judging the operation purpose or purpose of the construction industry registration system, it is very important to set up the system by rationally reviewing it. The purpose of this study is to examine the possibility of improvement in consideration of the risk factors related to the domestic construction industry registration industry classification system. To this end, we will conduct a case study on the construction industry classification system operated by overseas construction industry licenses or registration systems in Japan, the United States, and Australia, and compare it with the domestic industry classification system to derive implications and directions for improvement.

A Case Study on Care Workers' Experiences of Coping with Falls among Community-Dwelling Elders (재가노인 방문요양보호사의 낙상관련 대처 경험에 관한 연구)

  • Lim, Sun-Young;Park, Hye-Sun;Ma, Ryewon
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.99-110
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    • 2021
  • Purpose: The purpose of this study was to understand the experience and meaning of falls among care workers caring for the elderly. Methods: The participants comprised 10 care workers in Seoul and Gyeonggi Province, South Korea. The data collection period was from September to November 2020, and the data were obtained through individual in-depth interviews. The collected data were analyzed using the content analysis method of qualitative research. The main interview questions were as follows: First, in the event of a fall, "can you tell us about your experience and how you dealt with the fall?; second, "can you tell us about your role and the role of family members or the center that manages falls that occur outside of nursing visits.", third, "can you tell us about the difficulties in managing falls based on your experience?", and fourth, "how are falls that occur during nursing visits managed?" Results: As a result of analyzing the experiences of nursing care workers of falls while caring for elders in their homes, five main themes were derived. These were understanding the characteristics of the elderly at home, understanding possible emergency situations, providing caring services, minimizing physical harm, and delivering clear information. Conclusion: A significant finding of this study was that care workers who visit and provide care to elders at home confirmed the need for standard guidelines on appropriate responses in the event of a fall at home and the importance of managing emergencies arising from falls among elders at home. These results highlight the need for the development of emergency response education programs, such as programs on fall care among nurses and care workers who provide care to the elderly, and for enhanced understanding of the fall risk of elders who live at home.

Applied Time-Temperature Curve for Safety Evaluation in the Road Tunnel by Fire (도로터널내 화재에 따른 터널구조체의 안정성 평가를 위한 시간-온도곡선의 적용)

  • Won, Jong-Pil;Choi, Min-Jung;Jang, Chang-Il;Lee, Sang-Woo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.29 no.5A
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    • pp.551-555
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    • 2009
  • This study is performed to apply a standard to evaluate fire protection assessment for tunnel structures when a fire breaks out in the road tunnel. Recently, a number of road tunnels have been rapidly increased and fire risk also multiplyed according to extend tunnel length, due to natural features and environmentally-friendly road construction in Korea. But we have not yet been prescribed appropriate time-temperature curve for tunnel fire. Therefore, we presented fire design model and investigated time-temperature curve proposed by a foreign country considering traffic, a kinds of vehicles which are a basis of heat rate. At the end, Hydrocarbon modified curve applied as design fire model by using numerical analysis and presented design fire model and examined the effects of tunnel structures.

Development of Route following Algorithm for Application in Collision Avoidance Routes of Maritime Autonomous Surface Ship (자율운항선박의 회피 항로 적용을 위한 항로 추종 알고리즘 개발)

  • Seung-Tae Cha;Yu-jun Jeong
    • Journal of Navigation and Port Research
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    • v.47 no.6
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    • pp.386-393
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    • 2023
  • Recently, the demand for autonomous navigation technology has increased, and related research is also increasing. Autonomous ships generally follow the planned route, calculate the avoidance route according to the risk situation while sailing, and follow a calculated route. In general, an automatic steering device is used to follow the route, and among the operational automatic steering device methods, the route control mode is the most appropriate method to apply to autonomous ships. Therefore, in this study, we developed a route-tracking algorithm to apply an avoidance route using the navigation control mode of an automatic steering device. The algorithm was developed by dividing the straight and turning sections. A performance test was conducted to satisfy the performance suggested by IEC 62065, the relevant international standard, using simulator equipment that had acquired international certification to verify its performance. The results of the performance verification confirmed that the cross-track error, which represents the straight distance between the ship and the route, satisfied the performance standards suggested by IEC 62065 when the ship followed the route.