• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.264-271
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• 2018

Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

• International Journal of Computer Science & Network Security
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• 제23권5호
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• pp.89-94
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• 2023

Cloud-based technology is used in different organizations around the world for various purposes. Using this technology, the service providers provide the service mainly SaaS, PaaS and while the cloud service consumer consumes the services by paying for the service they used or accessed by the principle of "pay per use". The customer of the services can get any services being at different places or locations using different machines or electronic devices. Under the conditions of being well organized and having all necessary infrastructures, the services can be accessed suitably. The identified problem in this study is that cloud providers control and monitor the system or tools by ignoring the calculation and consideration of various faults made from the cloud provider side during service delivery. There are currently problems with ignoring the consumer or client during the monitoring and mentoring system for cloud services consumed at the customer or client level by SLA provisions. The new framework was developed to address the above-mentioned problems. The framework was developed as a unified modeling language. Eight basic components are used to develop the framework. For this research, the researcher developed a prototype by using a selected cloud tool to simulate and java programming language to write a code as well as MySQL to store data during SLA. The researcher used different criteria to validate the developed framework i.e. to validate SLA that is concerned with a cloud service provider, validate what happened when the request from the client-side is less than what is specified in SLA and above what is specified in SLA as well as implementing the monitoring mechanism using the developed Monitoring component. The researcher observed that with the 1st and 3rd criteria the service level agreement was violated and this indicated that if the Service level agreement is monitored or managed only by cloud service prover, there is a violation of LSA. Therefore, the researcher recommended that the service level agreement be managed by both cloud service providers and service consumers in the cloud computing environment.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제13권4호
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• pp.2198-2222
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• 2019

The cloud storage service becomes a rising trend based on the cloud computing, which promotes the remote data integrity auditing a hot topic. Some research can audit the integrity and correctness of user data and solve the problem of user privacy leakage. However, these schemes cannot use fewer data blocks to achieve better auditing results. In this paper, we figure out that the random sampling used in most auditing schemes is not well apply to the problem of cloud service provider (CSP) deleting the data that users rarely use, and we adopt the probability proportionate to size sampling (PPS) to handle such situation. A new scheme named improving audit efficiency of remote data for cloud storage is designed. The proposed scheme supports the public auditing with fewer data blocks and constrains the server's malicious behavior to extend the auditing cycle. Compared with the relevant schemes, the experimental results show that the proposed scheme is more effective.

• 유통과학연구
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• 제17권10호
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• pp.83-91
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• 2019

Purpose - Media is a significant distributional channel in sport. In terms of determining the influencer in building sport media contents, recent sport media studies have employed agenda-setting theory, assuming media itself as the agenda provider. In a real-world situation, however, sports stars have been deemed key factor determining distribution contents in sport. The starting point of this study is the "tacit premise" of agenda-setting theory. Given the agenda-setting theory, the current study attempted to explore the function of sport stars as an agenda provider, which is a key determinant of sport distribution. Research design, data, and methodology - This study has reviewed articles of Yuna Kim, Sang-hwa Lee, and Hyun-jin Ryu from daily newspapers including as dong-a ilbo and joongang ilbo (2013 to 2017). The study collected data, portable document format (PDF), from the online archive of dong-a ilbo and joongang ilbo. We coded the length of the article, the frequency, the size of the picture, and the structural form of the article. Inter-coder reliability was compared with data previously investigated by the researcher. Inter-coder reliabilities for study 1 and 2 was .89 and .85. To examine hypotheses, descriptive analysis, correlations, and cross-tap analysis were performed. Results - The results partially supported the hypotheses proposing the significant role of sports stars as the agenda setters in distributing sport media contents. In specific, the study found that the number of articles about sports stars prevailed the number of articles about regular athletes. Besides, studies found that the use of photos was more frequent in articles of sports starts than that of regular athletes. In sports newspaper articles, featured story articles were used more than straight-articles for news relating to sports stars. Also, sports newspaper of sports stars contained more information associated within an event rather than outside of an event. Conclusions - In sports journalism, this study challenges the current theory that the media affects the composition and the content of sports coverages. As the principle of the agenda-setting of sports media, the influence of sports stars must be continuously studied along with a follow-up study.

• 보건행정학회지
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• 제16권2호
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• 보건행정학회지
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• 제23권2호
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.

• 정보보호학회논문지
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• 제23권6호
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• pp.1259-1266
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• 2013

최근 데이터베이스의 크기가 점차 증가하고 있다. 기업에서는 데이터베이스 관리의 어려움으로 인하여 클라우드 형태로 아웃소싱하고 있으며, 이때 클라우드 서비스업체에 의해 관리되는 데이터베이스의 보안은 매우 중요하다. 데이터베이스 내의 중요 정보를 보호하기 위해서는 암호화하는 것이 최선의 방법이지만, 일단 암호화되고 난 후에는 더 이상 검색하기 어려워진다. 암호화된 데이터베이스에서의 검색 성능은 암호화 방법과 검색 방법에 의해 좌우된다. 본 논문에서는 가변길이의 키워드 인덱스와 블룸필터를 사용하여, 클라우드 서비스업체의 관리하의 데이터베이스에 대한 암호화 방법 및 효율적인 검색 방법을 제안한다. 마지막으로 제안된 방법이 데이터베이스 암호화 및 관련 응용분야에 유용하게 사용될 수 있음을 보인다.

• 한국인터넷방송통신학회논문지
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• 제12권4호
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• pp.111-118
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• 2012

다양한 방송사와 서로 다른 CP(Contents Provider)가 분산되어 있는 Data Center서버에서 VOD 서비스를 하고자 할 때, 서로 다른 CP 플랫폼들이 고화질 HD, 3DTV 비디오 등의 영상파일을 교환하기 위해 고성능 네트워크를 통하여 빠르게 전송할 수 있는 망을 빠르게 구성해야 한다. 본 논문은 Public망의 QoS와 보안성을 보완하는 선택적인 암호화 방안을 이용하여, 고속의 안전한 VPN(Virtual Privatr Network)을 생성하고 콘텐츠를 고속으로 대용량 영상파일을 전송하는 프로토콜을 제안한다. End to End의 Device가 대용량의 영상파일을 Parallel 전송으로 가용한 자원을 최대한 사용하면서 안전한 콘텐츠 전송이 가능한 고성능의 VPN을 구성하는 모델을 제안한다.

• 정보보호학회논문지
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• 제31권6호
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• pp.1157-1169
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• 2021

재해 복구는 자연 재해와 같은 비상 상황에 대비하여 서비스의 연속성을 보장하고, 리소스와 재정의 손실을 최소화하기 위한 정책 및 절차를 의미한다. 특히, 클라우드 서비스 제공자에 의한 재해 복구 방법은 관리의 유연성과 고가용성, 비용효율성과 같은 장점을 지닌다. 하지만, 이러한 방법은 서비스 사업자에 대한 의존성을 가지며, 개인의 데이터에 대해 사용자가 관여할 수 없는 구조적 한계를 가진다. 본 논문에서는 블록체인과 분산 스토리지를 활용하여 사용자의 데이터를 백업함으로써 서비스 제공자에 대한 의존성을 제거하고, 데이터의 기밀성을 위해 프록시 재암호화를 이용한 프로토콜을 제시한다. 제안된 방법은 이더리움과 IPFS 환경에서 구현되었으며, 백업 및 복구 운영에 필요한 성능과 비용을 제시한다.

• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.298-303
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• 2024

Objectives: The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities. Methods: Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis. Results: In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions. Conclusions: In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.