• 제목/요약/키워드: Diagnosis of performance

검색결과 1,532건 처리시간 0.028초

암 환자의 임상영양치료를 위한 임상영양사의 직무분석과 직무표준 개발 (Development of Job Standards of Clinical Dietitian for the Clinical Nutrition Therapy to Cancer Patients in Hospitals)

  • 최수경;위경애;이송미;김은미;박미선;손정민;우미혜;주달래;차진아;서정숙
    • 대한영양사협회학술지
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    • 제21권2호
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    • pp.91-109
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    • 2015
  • The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

Diagnostic Value of 18F-FDG PET/CT in Comparison to Bone Scintigraphy, CT and 18F-FDG PET for the Detection of Bone Metastasis

  • Liu, Ning-Bo;Zhu, Lei;Li, Ming-Huan;Sun, Xiao-Rong;Hu, Man;Huo, Zong-Wei;Xu, Wen-Gui;Yu, Jin-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3647-3652
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    • 2013
  • Purpose: To evaluate the diagnostic value of $^{18}F$-FDG PET/CT for detection of bone metastasis in comparison with the efficacies of $^{18}F$-FDG PET/CT, CT, $^{18}F$-FDG PET and conventional planar bone scintigraphy in a series of cancer patients. Methods: Five hundred and thirty patients who underwent both $^{18}F$-FDG PET/CT and bone scintigraphy within 1 month were retrospectively analyzed. The skeletal system was classified into 10 anatomic segments and interpreted blindly and separately. For each modality, the sensitivity, specificity, accuracy, PPV and NPV were calculated and the results were statistically analyzed. Results: Bone metastases were confirmed in 117 patients with 459 positive segments. On patient-based analysis, the sensitivity, specificity, accuracy, PPV and NPV of $^{18}F$-FDG PET/CT were significantly higher than bone scintigraphy, CT and $^{18}F$-FDG PET (P<0.05). On segment-based analysis, the sensitivity of CT, bone scintigraphy, $^{18}F$-FDG PET and $^{18}F$-FDG PET/CT were 70.4%, 89.5%, 89.1% and 97.8%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The overall specificity and accuracy of the four modalities were 89.1%, 91.8%, 90.3%, 98.2% and 90.3%, 90.9%, 89.8%, 98.0%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The PPV and NPV were 89.8%, 87.6%, 85.6%, 97.2% and 85.6%, 93.2%, 92.8%, 98.6%, respectively. Three hundred and twelve lesions or segments were presented as lytic or sclerotic changes on CT images at the corresponding sites of increased $^{18}F$-FDG uptake. In lytic or mixed lesions, the sensitivity of $^{18}F$-FDG PET/CT and $^{18}F$-FDG PET were better than bone scintigraphy, while in osteoblastic lesions bone scintigraphy had a similar performance with $^{18}F$-FDG PET/CT but better than $^{18}F$-FDG PET alone. Conclusion: Our data allow the conclusion that $^{18}F$-FDG PET/CT is superior to planar bone scintigraphy, CT or $^{18}F$-FDG PET in detecting bone metastasis. $^{18}F$-FDG PET/CT may enhance our diagnosis of tumor bone metastasis and provide more information for cancer treatment.

Pre-operative Predictive Factors for Intra-operative Pathological Lymph Node Metastasis in Rectal Cancers

  • Gao, Chun;Li, Jing-Tao;Fang, Long;Wen, Si-Wei;Zhang, Lei;Zhao, Hong-Chuan
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6293-6299
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    • 2013
  • Background: A number of clinicopathologic factors have been found to be associated with pathological lymph node metastasis (pLNM) in rectal cancer; however, most of them can only be identified by expensive high resolution imaging or obtained after surgical treatment. Just like the Child-Turcotte-Pugh (CTP) and the model for end-stage liver disease (MELD) scores which have been widely used in clinical practice, our study was designed to assess the pre-operative factors which could be obtained easily to predict intra-operative pLNM in rectal cancer. Methods: A cohort of 469 patients who were treated at our hospital in the period from January 2003 to June 2011, and with a pathologically hospital discharge diagnosis of rectal cancer, were included. Clinical, laboratory and pathologic parameters were analyzed. A multivariate unconditional logistic regression model, areas under the curve (AUC), the Kaplan-Meier method (log-rank test) and the Cox regression model were used. Results: Of the 469 patients, 231 were diagnosed with pLNM (49.3%). Four variables were associated with pLNM by multivariate logistic analysis, age<60 yr (OR=1.819; 95% CI, 1.231-2.687; P=0.003), presence of abdominal pain or discomfort (OR=1.637; 95% CI, 1.052-2.547; P=0.029), absence of allergic history (OR=1.879; 95% CI, 1.041-3.392; P=0.036), and direct $bilirubin{\geq}2.60{\mu}mol/L$ (OR=1.540; 95% CI, 1.054-2.250; P=0.026). The combination of all 4 variables had the highest sensitivity (98.7%) for diagnostic performance. In addition, age<60 yr and direct $bilirubin{\geq}2.60{\mu}mol/L$ were found to be associated with prognosis. Conclusion: Age, abdominal pain or discomfort, allergic history and direct bilirubin were associated with pLNM, which may be helpful for preoperative selection.

Modeling of CO2 Emission from Soil in Greenhouse

  • Lee, Dong-Hoon;Lee, Kyou-Seung;Choi, Chang-Hyun;Cho, Yong-Jin;Choi, Jong-Myoung;Chung, Sun-Ok
    • 원예과학기술지
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    • 제30권3호
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    • pp.270-277
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    • 2012
  • Greenhouse industry has been growing in many countries due to both the advantage of stable year-round crop production and increased demand for fresh vegetables. In greenhouse cultivation, $CO_2$ concentration plays an essential role in the photosynthesis process of crops. Continuous and accurate monitoring of $CO_2$ level in the greenhouse would improve profitability and reduce environmental impact, through optimum control of greenhouse $CO_2$ enrichment and efficient crop production, as compared with the conventional management practices without monitoring and control of $CO_2$ level. In this study, a mathematical model was developed to estimate the $CO_2$ emission from soil as affected by environmental factors in greenhouses. Among various model types evaluated, a linear regression model provided the best coefficient of determination. Selected predictor variables were solar radiation and relative humidity and exponential transformation of both. As a response variable in the model, the difference between $CO_2$ concentrations at the soil surface and 5-cm depth showed are latively strong relationship with the predictor variables. Segmented regression analysis showed that better models were obtained when the entire daily dataset was divided into segments of shorter time ranges, and best models were obtained for segmented data where more variability in solar radiation and humidity were present (i.e., after sun-rise, before sun-set) than other segments. To consider time delay in the response of $CO_2$ concentration, concept of time lag was implemented in the regression analysis. As a result, there was an improvement in the performance of the models as the coefficients of determination were 0.93 and 0.87 with segmented time frames for sun-rise and sun-set periods, respectively. Validation tests of the models to predict $CO_2$ emission from soil showed that the developed empirical model would be applicable to real-time monitoring and diagnosis of significant factors for $CO_2$ enrichment in a soil-based greenhouse.

노인에서 치매 조기선별을 위한 시각.금전계산 검사의 유용성 (Availability of the Time and Change Test in Screening for Dementia in the Elderly)

  • 정은경;신민호;이정애
    • Journal of Preventive Medicine and Public Health
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    • 제36권2호
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    • pp.101-107
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    • 2003
  • Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.

심장비대증 환자의 흉부 X선 영상에 대한 Inception V3 알고리즘의 분류 성능평가 (Evaluation of Classification Performance of Inception V3 Algorithm for Chest X-ray Images of Patients with Cardiomegaly)

  • 정우연;김정훈;박지은;김민정;이종민
    • 한국방사선학회논문지
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    • 제15권4호
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    • pp.455-461
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    • 2021
  • 심장비대증은 흉부 X선 영상에서 흔히 보이는 질병 중 하나이지만 조기에 발견을 하지 못하면 심각한 합병증을 유발할 수도 있다. 이러한 점을 고려하여 최근에는 여러 과학기술 분야의 발전으로 인공지능을 이용한 딥러닝 알고리즘을 의료에 접목시키는 영상 분석 연구들이 많이 진행되고 있다. 본 논문에서는 Inception V3 딥러닝 모델을 흉부 X선 영상을 이용하여 심장비대증의 분류에 유용한 모델인지 평가하고자 한다. 사용된 영상의 경우 총 1026장의 경북대학교병원 내 정상 심장 진단을 받은 환자와 심장비대증 진단을 받은 환자의 흉부 X선 영상을 사용하였다. 실험결과 Inception V3 딥러닝 모델의 심장비대증 유무에 따른 분류 정확도와 손실도 결과값은 각각 96.0%, 0.22%의 결과값을 나타내었다. 연구결과를 통해 Inception V3 딥러닝 모델은 흉부 영상 데이터의 특징 추출 및 분류에 있어 우수한 딥러닝 모델인 것을 알 수 있었다. Inception V3 딥러닝 모델의 경우 흉부 질환의 분류에 있어 유용한 딥러닝 모델이 될 것으로 판단되며 조금 더 다양한 의료 영상 데이터를 이용한 연구를 진행하여 이와 같은 우수한 연구결과를 얻게 된다면 향후 임상의의 진단 시 많은 도움을 줄 수 있을 것으로 사료된다.

선박용 밸브의 내부 누설 진단을 위한 음향방출신호의 머신러닝 기법 적용 연구 (Diagnosis of Valve Internal Leakage for Ship Piping System using Acoustic Emission Signal-based Machine Learning Approach)

  • 이정형
    • 해양환경안전학회지
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    • 제28권1호
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    • pp.184-192
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    • 2022
  • 밸브의 내부 누설 현상은 밸브의 내부 부품의 손상에 의해 발생하며 배관 시스템의 사고와 운전정지를 일으키는 주요 요인이다. 본 연구는 버터플라이형 밸브의 내부 누설에 따라 배관계에서 발생하는 음향방출 신호를 이용하여 배관 가동 중 실시간 누설 진단의 가능성을 검토하였다. 이를 위해 밸브의 작동 모드별로 측정한 시간영역의 AE 원시신호를 취득하였으며 이로부터 구축한 데이터셋은 데이터 기반의 인공지능 알고리즘에 적용하여 밸브의 내부 누설 유무를 진단하는 모델을 생성하였다. 누설 유무진단을 분류의 문제로 정의하여 SVM 기반의 머신러닝과 CNN 기반의 딥러닝 분류 알고리즘을 적용하였다. 데이터의 특징 추출에 기반한 SVM 분류 모델의 경우, 이진분류 모델에서 구축된 모델에 따라 83~90%의 정확도를 나타냈으며, 다중 클래스인 경우 분류 정확도가 66%로 감소하였다. 반면, CNN 기반의 다중 클래스 분류 모델의 경우 99.85%의 분류 정확도를 얻을 수 있었다. 결론적으로 밸브 내부 누설 진단을 위한 SVM 분류모델은 다중 클래스의 정확도 향상을 위해 적절한 특징 추출이 필요하며, CNN 기반의 분류모델은 프로세서의 성능 저하만 없다면 누설진단과 밸브 개도 분류에 효율적인 접근방법임을 확인하였다.

국내 프랜차이즈 기업의 CSR 단계별 평가 및 제고 방안 (The Study on Evaluation of Franchise Corporate Social Responsibility)

  • 박진용;채단비;임지원
    • 한국프랜차이즈경영연구
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    • 제5권1호
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    • pp.109-141
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    • 2014
  • 최근 기업의 사회적 책임 활동에 관한 소비자의 관심은 꾸준히 증가하고 있으며, 이러한 소비자 차원에서의 CSR 이행 여부는 기업의 제품 혹은 서비스에 대한 전반적인 이미지로 평가된다. 뿐만 아니라 이는 기업의 매출액에 직·간접적으로 영향을 미치기도 한다. 이와 더불어 기술력의 부재 등으로 인해 기업의 경쟁력 제고는 점차적으로 힘들어지고 있으며, 소비자들의 구매력 및 만족도 제고를 위한 CSR 수행 등과 같은 기업의 명성에 더욱 의존하는 구조로써 변화되고 있다. 이에 기업들은 여러 자선사업이나 기부활동, 각종 프로그램 지원, 환경 친화적 제품 개발 등과 같은 CSR 수행에 많은 비용을 지출하고 있는 실정이다. 이에 따라 본 연구는 프랜차이즈 업계의 CSR을 통한 소비자의 기업 평판 및 인식 제고, 프랜차이즈 기업이 추구하는 자원(상품 및 서비스) 활용도를 높이고 효과적인 프랜차이즈 업계의 CSR 프로그램 구축방안 마련을 목적으로 한다. 이를 위해 기존 연구 및 국내외 CSR 사례를 통해 수준별 단계 모델을 제시하고, 국내 프랜차이즈 업계가 추구해야 할 CSR의 전반적인 방향성을 제시하였다. 기존연구 고찰 및 국내외 기업들의 CSR 현황 검토를 통한 본 연구 결과, CSR의 단계적 수준은 총 네 가지 형태로 제시되었다. 그러나 사례 검토를 통해 국내 프랜차이즈 기업의 CSR 수준은 1, 2단계의 수준으로 나타나는 것으로 확인되었다.

간 섬유화 단계 평가를 위한 회색조 초음파 영상 기반 텍스처 분석 (Texture Analysis of Gray-Scale Ultrasound Images for Staging of Hepatic Fibrosis)

  • 박언주;김승호;박상준;백태욱
    • 대한영상의학회지
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    • 제82권1호
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    • pp.116-127
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    • 2021
  • 목적 간 섬유화 단계 평가를 위한 회색조 초음파 영상 기반 텍스처 분석 측정 변수들의 진단적 유용성에 대해 평가한다. 대상과 방법 간 회색조 초음파 검사를 시행한 총 167명의 환자를 대상으로 하였다. 텍스처 분석은 한 명의 의사가 전용 소프트웨어를 이용하여 시행하였으며 3, 5, 6, 7, 8번 간 분절에 20픽셀에 해당하는 원형 관심 영역을 지정하여 측정하였다. 간 섬유화 정도에 대한 표준 품으로는 fibrosis-4 (이하 FIB-4 index)를 사용하였다. 산출된 텍스처 변수들과 간의 섬유화 정도의 비교는 t-검정과 Mann-Whitney U 검정을 사용하였으며, 진단적으로 유의한 변수들에 대하여 수신자 운영 특성 곡선의 곡선 하 면적(area under the receiver operating characteristic curve)으로 진단능을 평가하였다. 결과 연구에 포함된 환자는 정상군(FIB-4 < 1.45, n = 50), 경도(1.45 ≤ FIB-4 ≤ 2.35, n = 37), 중등도(2.35 < FIB-4 ≤ 3.25, n = 27)와 중증 간 섬유화군(FIB-4 > 3.25, n = 53)으로 구분되었다. 간의 5번 분절에서 왜도는 정상군과 경도군 사이에서 통계적으로 유의한 차이를 보였다(각각 0.2392 ± 0.3361, 0.4134 ± 0.3004, p = 0.0109). 정상군과 경도군을 구별하기 위한 왜도의 곡선 하 면적은 0.660 (95% confidence interval, 0.551-0.758) 이었으며, 추정 정확도, 민감도, 특이도는 각각 64%, 87%, 48%로 산출되었다. 결론 왜도는 5번 간 분절에서 정상군과 경도 섬유화군을 구분하는 데 유의한 차이를 보였다.

Radiolabeling of 11C-sertraline by fast and easy loop method with [11C]CH3OTf

  • Lee, Hak Jeong;Jeong, Jae Min;Lee, Sang-Yoon;Ido, Tatsuo
    • 대한방사성의약품학회지
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    • 제3권1호
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    • pp.32-37
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    • 2017
  • Cis-(1S,4S)-4-(3,4-dichlorophenyl)-1,2,3,4-tertrahydro-N-methyl-1-naphthalenamine (sertraline) hydrochloride from among selective serotonin reuptake inhibitors (SSRIs) is a treatment of major depression. For the differential diagnosis by metabolizing serotonin in a patient with neurological disorders, the radiolabeled $^{11}C$-sertraline was developed for non-invasive positron emission tomography in living brain and use the evaluation of new drug for SSRIs. We release the results of a fast and easy radiolabeling method applied a one-step loop method with $[^{11}C]CH_3OTf$ for routine clinical applications of $^{11}C$-sertraline. 1 mg of a precursor for $^{11}C$-sertraline in 0.1 mL DMF and $5{\mu}L$ of 1N NaOH, were injected into the loop of semi-prep high-performance liquid chromatography (HPLC). $[^{11}C]CH_3OTf$ was passed through the loop at room temperature (RT). The $^{11}C$-sertraline was separated by the semi-preparative HPLC. $^{11}C$-sertraline was eluted at 28.0 min was collected and evaluated by analytical HPLC and mass spectrometer. The total radiolabeling efficiency of $^{11}C$-sertraline was $30.7{\pm}8.7%$. The specific activity was $64.8{\pm}51.4GBq/{\mu}mol$. The radiochemical and chemical purities were higher than 99%. The mass spectrum of the product showed m/z peaks at 307.1 (M+1), indicating the mass of sertraline. By the one-step loop method with $[^{11}C]CH_3OTf$, $^{11}C$-sertraline could be quickly and easily prepared for clinical application.