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The Importance of Early Surgical Decompression for Acute Traumatic Spinal Cord Injury

  • Lee, Dong-Yeong;Park, Young-Jin;Song, Sang-Youn;Hwang, Sun-Chul;Kim, Kun-Tae;Kim, Dong-Hee
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.448-454
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    • 2018
  • Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.

The Impact of CPO Characteristics on Organizational Privacy Performance (개인정보보호책임자의 특성이 개인정보보호 성과에 미치는 영향)

  • Wee, Jiyoung;Jang, Jaeyoung;Kim, Beomsoo
    • Asia pacific journal of information systems
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    • v.24 no.1
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    • pp.93-112
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    • 2014
  • As personal data breach reared up as a problem domestically and globally, organizations appointing chief privacy officers (CPOs) are increasing. Related Korean laws, 'Personal Data Protection Act' and 'the Act on Promotion of Information and Communication Network Utilization and Information Protection, etc.' require personal data processing organizations to appoint CPOs. Research on the characteristics and role of CPO is called for because of the importance of CPO being emphasized. There are many researches on top management's role and their impact on organizational performance using the Upper Echelon theory. This study investigates what influence the characteristics of CPO gives on the organizational privacy performance. CPO's definition varies depending on industry, organization size, required responsibility and power. This study defines CPO as 'a person who takes responsibility for all the duties on handling the organization's privacy,' This research assumes that CPO characteristics such as role, personality and background knowledge have an influence on the organizational privacy performance. This study applies the part relevant to the upper echelon's characteristics and performance of the executives (CEOs, CIOs etc.) for CPO. First, following Mintzberg and other managerial role classification, information, strategic, and diplomacy roles are defined as the role of CPO. Second, the "Big Five" taxonomy on individual's personality was suggested in 1990. Among these five personalities, extraversion and conscientiousness are drawn as the personality characteristics of CPO. Third, advance study suggests complex knowledge of technology, law and business is necessary for CPO. Technical, legal, and business background knowledge are drawn as the background knowledge of CPO. To test this model empirically, 120 samples of data collected from CPOs of domestic organizations are used. Factor analysis is carried out and convergent validity and discriminant validity were verified using SPSS and Smart PLS, and the causal relationships between the CPO's role, personality, background knowledge and the organizational privacy performance are analyzed as well. The result of the analysis shows that CPO's diplomacy role and strategic role have significant impacts on organizational privacy performance. This reveals that CPO's active communication with other organizations is needed. Differentiated privacy policy or strategy of organizations is also important. Legal background knowledge and technical background knowledge were also found to be significant determinants to organizational privacy performance. In addition, CPOs conscientiousness has a positive impact on organizational privacy performance. The practical implication of this study is as follows: First, the research can be a yardstick for judgment when companies select CPOs and vest authority in them. Second, not only companies but also CPOs can judge what ability they should concentrate on for development of their career relevant to their job through results of this research. Cultural social value, citizen's consensus on the right to privacy, expected CPO's role will change in process of time. In future study, long-term time-series analysis based research can reveal these changes and can also offer practical implications for government and private organization's policy making on information privacy.

Clinical and Radiological Outcomes of Foraminal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Lumbar Foraminal Stenosis

  • Kim, Ju-Eun;Choi, Dae-Jung;Park, Eugene J.
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.439-447
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    • 2018
  • Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using $0^{\circ}$ or $30^{\circ}$ endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of $0^{\circ}$ or $30^{\circ}$ endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). Results: The IVA significantly increased from $6.24^{\circ}{\pm}4.27^{\circ}$ to $6.96^{\circ}{\pm}3.58^{\circ}$ at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from $6.27^{\circ}{\pm}3.12^{\circ}$ to $6.04^{\circ}{\pm}2.41^{\circ}$, but the difference was not statistically significant (p = 0.375). The percentage of slip was $3.41%{\pm}5.24%$ preoperatively and $6.01%{\pm}1.43%$ at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was $2.90%{\pm}3.37%$; at 1 year postoperatively, it was $3.13%{\pm}4.11%$ (p = 0.720), showing no significant difference. The DHI changed from $34.78%{\pm}9.54%$ preoperatively to $35.05%{\pm}8.83%$ postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from $55.15%{\pm}9.45%$ preoperatively to $54.56%{\pm}9.86%$ postoperatively, but the results were not statistically significant (p = 0.705). Conclusions: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.

How to Avoid Graft-Tunnel Length Mismatch in Modified Transtibial Technique for Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Graft

  • Ko, Dukhwan;Kim, Hyeung-June;Oh, Seong-Hak;Kim, Byung-June;Kim, Sung-Jae
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.407-412
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    • 2018
  • Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels - the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients' height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.

An Empirical Study on the Influencing Factors of Perceived Job Performance in the Context of Enterprise Mobile Applications (업무성과에 영향을 주는 업무용 모바일 어플리케이션의 주요 요인에 관한 연구)

  • Chung, Sunghun;Kim, Kimin
    • Asia pacific journal of information systems
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    • v.24 no.1
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    • pp.31-50
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    • 2014
  • The ubiquitous accessibility of information through mobile devices has led to an increased mobility of workers from their fixed workplaces. Market researchers estimate that by 2016, 350 million workers will be using their smartphones for business purposes, and the use of smartphones will offer new business benefits. Enterprises are now adopting mobile technologies for numerous applications to increase their operational efficiency, improve their responsiveness and competitiveness, and cultivate their innovativeness. For these reasons, various organizational aspects concerning "mobile work" have received a great deal of recent attention. Moreover, many CIOs plan to allocate a considerable amount of their budgets mobile work environments. In particular, with the consumerization of information technology, enterprise mobile applications (EMA) have played a significant role in the explosive growth of mobile computing in the workplace, and even in improving sales for firms in this field. EMA can be defined as mobile technologies and role-based applications, as companies design them for specific roles and functions in organizations. Technically, EMA can be defined as business enterprise systems, including critical business functions that enable users to access enterprise systems via wireless mobile devices, such as smartphones or tablets. Specifically, EMA enables employees to have greater access to real-time information, and provides them with simple features and functionalities that are easy for them to complete specific tasks. While the impact of EMA on organizational workers' productivity has been given considerable attention in various literatures, relatively little research effort has been made to examine how EMA actually lead to users' job performance. In particular, we have a limited understanding of what the key antecedents are of such an EMA usage outcome. In this paper, we focus on employees' perceived job performance as the outcome of EMA use, which indicates the successful role of EMA with regard to employees' tasks. Thus, to develop a deeper understanding of the relationship among EMA, its environment, and employees' perceived job performance, we develop a comprehensive model that considers the perceived-fit between EMA and employees' tasks, satisfaction on EMA, and the organizational environment. With this model, we try to examine EMA to explain how job performance through EMA is revealed from both the task-technology fit for EMA and satisfaction on EMA, while also considering the antecedent factors for these constructs. The objectives of this study are to address the following research questions: (1) How can employees successfully manage EMA in order to enhance their perceived job performance? (2) What internal and/or external factors are important antecedents in increasing EMA users' satisfaction on MES and task-technology fit for EMA? (3) What are the impacts of organizational (e.g. organizational agility), and task-related antecedents (e.g., task mobility) on task-technology fit for EMA? (4) What are the impacts of internal (e.g., self-efficacy) and external antecedents (e.g., system reputation) for the habitual use of EMA? Based on a survey from 254 actual employees who use EMA in their workplace across industries, our results indicate that task-technology fit for EMA and satisfaction on EMA are positively associated with job performance. We also identify task mobility, organizational agility, and system accessibility that are found to be positively associated with task-technology fit for EMA. Further, we find that external factor, such as the reputation of EMA, and internal factor, such as self-efficacy for EMA that are found to be positively associated with the satisfaction of EMA. The present findings enable researchers and practitioners to understand the role of EMA, which facilitates organizational workers' efficient work processes, as well as the importance of task-technology fit for EMA. Our model provides a new set of antecedents and consequence variables for a TAM involving mobile applications. The research model also provides empirical evidence that EMA are important mobile services that positively influence individuals' performance. Our findings suggest that perceived organizational agility and task mobility do have a significant influence on task-technology fit for EMA usage through positive beliefs about EMA, that self-efficacy and system reputation can also influence individuals' satisfaction on EMA, and that these factors are important contingent factors for the impact of system satisfaction and perceived job performance. Our findings can help managers gauge the impact of EMA in terms of its contribution to job performance. Our results provide an explanation as to why many firms have recently adopted EMA for efficient business processes and productivity support. Our findings additionally suggest that the cognitive fit between task and technology can be an important requirement for the productivity support of EMA. Further, our study findings can help managers in formulating their strategies and building organizational culture that can affect employees perceived job performance. Managers, thus, can tailor their dependence on EMA as high or low, depending on their task's characteristics, to maximize the job performance in the workplace. Overall, this study strengthens our knowledge regarding the impact of mobile applications in organizational contexts, technology acceptance and the role of task characteristics. To conclude, we hope that our research inspires future studies exploring digital productivity in the workplace and/or taking the role of EMA into account for employee job performance.

An Empirical Study on the Impact of the Perception of the Monitoring Function on Effective BPMS Adoption (모니터링 기능에 대한 인식이 효과적인 BPMS 도입에 미치는 영향)

  • Chae, Myung-Sin;Park, Jin-Suk;Lee, Byung-Tae
    • Asia pacific journal of information systems
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    • v.17 no.3
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    • pp.105-130
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    • 2007
  • Recently, there is a substantial interest in implementing Business Process Management System(BPMS) among enterprises with the purpose of business process innovation. BPMS redesigns and coordinates business processes in terms of both automated steps and human involvement in order to maximize the value of both involved people and systems. The reason why BPMS is getting attention from top managers is that it has the possibility to optimize the business processes by cycling the process of modeling, execution, monitoring, evaluation, and redesigning work processes. Thus, it has created high expectations about not only productivity improvement but also business process innovation. However. having an innovative nature, which is used for process innovation, BPMS implementation has great potential to stir up employee resistance. The analysis and the discussion about the prevention of the resistance against IS(Information Systems) is important because IS change the way people work and also alter the power structure within the organization, in general. The purpose of this study is to investigate factors that have an impact on the effective adoption of BPMS at the enterprise level. To find out these factors, this study considers two characteristics of BPMS: First. BPMS shares some characteristics with other enterprise-wide IS such as ERP. Second, it has special BPMS-specific characteristics. Due to the lack of previous research on BPMS adoption, interviews were carried out with IT-consultants and CIOs who conducted BPMS projects previously to find out BPMS-specific features that would make BPMS unique when compared to other enterprise-wide IS. As a result, the monitoring function was chosen as the main BPMS-specific factor. Thus, this paper reviewed studies both on enterprise-wide IS adoptions, which applied Technology Acceptance Model (TAM) and secondly on computer based monitoring to find out factors that would influence the employees' perception on the monitoring function of BPMS. Based on the literature review, the study suggested three factors that would have an impact on the employee's perception of the monitoring function: fairness of enterprise evaluation system, fairness of the boss, and self-efficacy of their work. Three factors that would impact the enterprise-wide IS adoption were also set: the shared belief in the benefit of BPMS, training, and communication. Then, these factors were integrated with TAM. Structural equation modeling was used to test hypotheses, out factors that would impact the employees' perception on the monitoring function of BPMS. Based on the literature review the study suggested three factors that would have an impact on the employee's perception of the monitoring function: fairness of enterprise evaluation system, fairness of the boss, and self-efficacy of their work. Three factors that would impact the enterprise-wide IS adoption were also set: the shared belief in the benefit of BPMS, training, and communication. Then, these factors were integrated with TAM. Structural equation modeling was used to test hypotheses. The data analysis results showed that two among three monitoring function related factors - enterprise evaluation system and fairness of the boss - were significant. This implies that employees would worry less about the BPMS implementation as long as they perceive the monitoring results will be used fairly for their performance evaluation. However, employees' high self-efficacy on their job was not a significant factor in their perception of the usefulness of BPMS. This is related to cases that showed employees resisted against the information systems because they automated their works (Markus, 1983). One specific case was an electronic company, where the accounting department workers were requested to redefine their job because their working processes were automated due to BPMS implementation.