• Journal of Digital Convergence
• /
• v.17 no.2
• /
• pp.217-230
• /
• 2019

This study was conducted to develop a customized severity-adjustment method and to evaluate their validity for acute myocardial infarction(AMI) patients to complement the limitations of the existing severity-adjustment method for comorbidities. For this purpose, the subjects of KCD-7 code I20.0 ~ I20.9, which is the main diagnosis of acute myocardial infarction were extracted using the Korean National Hospital Discharge In-depth Injury survey data from 2006 to 2015. Three tools were used for severity-adjustment method of comorbidities : CCI (charlson comorbidity index), ECI (Elixhauser comorbidity index) and the newly proposed CCS (Clinical Classification Software). The results showed that CCS was the best tool for the severity correction, and that support vector machine model was the most predictable. Therefore, we propose the use of the customized method of severity correction and machine learning techniques from this study for the future research on severity adjustment such as assessment of results of medical service.

• Journal of the Korean Orthopaedic Association
• /
• v.52 no.1
• /
• pp.73-82
• /
• 2017

Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

• Journal of Chest Surgery
• /
• v.56 no.4
• /
• pp.244-251
• /
• 2023

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.

• Proceedings of the Korea Water Resources Association Conference
• /
• 2021.06a
• /
• pp.246-246
• /
• 2021

본 연구는 강우 발생시 유량을 추정하는 것에 목적이 있다. 이를 위해 본 연구는 선행연구의 모형 개발방법론에서 벗어나 딥러닝 알고리즘 중 하나인 합성곱 신경망 (convolution neural network)과 수문학적 이미지 (hydrological image)를 이용하여 강우 발생시 유량을 추정하였다. 합성곱 신경망은 일반적으로 분류 문제 (classification)을 해결하기 위한 목적으로 개발되었기 때문에 불특정 연속변수인 유량을 모의하기에는 적합하지 않다. 이를 위해 본 연구에서는 합성곱 신경망의 완전 연결층 (Fully connected layer)를 개선하여 연속변수를 모의할 수 있도록 개선하였다. 대부분 합성곱 신경망은 RGB (red, green, blue) 사진 (photograph)을 이용하여 해당 사진이 나타내는 것을 예측하는 목적으로 사용하지만, 본 연구의 경우 일반 RGB 사진을 이용하여 유출량을 예측하는 것은 경험적 모형의 전제(독립변수와 종속변수의 관계)를 무너뜨리는 결과를 초래할 수 있다. 이를 위해 본 연구에서는 임의의 유역에 대해 2차원 공간에서 무차원의 수문학적 속성을 갖는 grid의 집합으로 정의되는 수문학적 이미지는 입력자료로 활용했다. 합성곱 신경망의 구조는 Convolution Layer와 Pulling Layer가 5회 반복하는 구조로 설정하고, 이후 Flatten Layer, 2개의 Dense Layer, 1개의 Batch Normalization Layer를 배열하고, 다시 1개의 Dense Layer가 이어지는 구조로 설계하였다. 마지막 Dense Layer의 활성화 함수는 분류모형에 이용되는 softmax 또는 sigmoid 함수를 대신하여 회귀모형에서 자주 사용되는 Linear 함수로 설정하였다. 이와 함께 각 층의 활성화 함수는 정규화 선형함수 (ReLu)를 이용하였으며, 모형의 학습 평가 및 검정을 판단하기 위해 MSE 및 MAE를 사용했다. 또한, 모형평가는 NSE와 RMSE를 이용하였다. 그 결과, 모형의 학습 평가에 대한 MSE는 11.629.8 m3/s에서 118.6 m3/s로, MAE는 25.4 m3/s에서 4.7 m3/s로 감소하였으며, 모형의 검정에 대한 MSE는 1,997.9 m3/s에서 527.9 m3/s로, MAE는 21.5 m3/s에서 9.4 m3/s로 감소한 것으로 나타났다. 또한, 모형평가를 위한 NSE는 0.7, RMSE는 27.0 m3/s로 나타나, 본 연구의 모형은 양호(moderate)한 것으로 판단하였다. 이에, 본 연구를 통해 제시된 방법론에 기반을 두어 CNN 모형 구조의 확장과 수문학적 이미지의 개선 또는 새로운 이미지 개발 등을 추진할 경우 모형의 예측 성능이 향상될 수 있는 여지가 있으며, 원격탐사 분야나, 위성 영상을 이용한 전 지구적 또는 광역 단위의 실시간 유량 모의 분야 등으로의 응용이 가능할 것으로 기대된다.

• Clinical and Experimental Pediatrics
• /
• v.51 no.11
• /
• pp.1158-1164
• /
• 2008

Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

• Journal of the Korean Society of Hazard Mitigation
• /
• v.8 no.6
• /
• pp.137-148
• /
• 2008

There have been many cases of using wetlands as an alternative in controlling stormwater, treating mining leachate, and agricultural discharge, and so on, recently. The reality is, however, that the wetlands are not properly applicable because of the lack of enough longterm data for wetlands due to the difficulty of long-term monitoring. Therefore, this study tries to analyze the storage of Upo, Mokpo, Sajipo, and Jjokjibeul in Topyeong watershed using SWAT(Soil and Water Assessment Tool) model, one of the long-term runoff hydrologic model, for the purpose of generating the long-term data and analyzing the hydrologic behavior of wetlands based on the generated data. Also, the changes in runoff at the outlet are analyzed after applying the simulation of constructing washland in Topyeong watershed and the storage in Upo is analyzed. The result shows that the runoff at the outlet of the watershed is decreased in rainy season from July to August and increased in dry season from December to February. In addition, the analysis of Upo storage concludes that Upo can be influenced by the construction of the washland. The duration curve of washland is then analyzed in order to evaluate the wetland's sustainability in terms of washland and it appears that the runoff of washland is simulated to be less than that of the existing wetland. Moreover, runoffs of some washlands are simulated to be less even in wet season. These results lead to the fact that there should be further hydrologic management for constructed washland. Then, the changes in loads (TN and TP) because of constructing washland are analyzed. The result shows that the loads are reduced because of the construction. Also, the changes in loads due to the construction of buffer strips are analyzed to compare the load reductions caused by a washland. Finally, REMM model, a riparian management model, is applied to overcome the hydrologic ambiguousness of SWAT model, and then, the SWAT model results are compared to those of REMM.

• KSCE Journal of Civil and Environmental Engineering Research
• /
• v.33 no.6
• /
• pp.2255-2265
• /
• 2013

This study presents the width function-based Clark model. To this end, rescaled width function with distinction between hillslope and channel velocity is used as time-area curve and then it is routed through linear storage within the framework of not finite difference scheme used in original Clark model but analytical expression of linear storage routing. There are three parameters focused in this study: storage coefficient, hillslope velocity and channel velocity. SCE-UA, one of the popular global optimization methods, is applied to estimate them. The shapes of resulting IUHs from this study are evaluated in terms of the three statistical moments of hydrologic response functions: mean, variance and the third moment about the center of IUH. The correlation coefficients to the three statistical moments simulated in this study against these of observed hydrographs were estimated at 0.995 for the mean, 0.993 for the variance and 0.983 for the third moment about the center of IUH. The shape of resulting IUHs from this study give rise to satisfactory simulation results in terms of the mean and variance. But the third moment about the center of IUH tend to be overestimated. Clark model proposed in this study is superior to the one only taking into account mean and variance of IUH with respect to skewness, peak discharge and peak time of runoff hydrograph. From this result it is confirmed that the method suggested in this study is useful tool to reflect the heterogeneity of drainage path and hydrodynamic parameters. The variation of statistical moments of IUH are mainly influenced by storage coefficient and in turn the effect of channel velocity is greater than the one of hillslope velocity. Therefore storage coefficient and channel velocity are the crucial factors in shaping the form of IUH and should be considered carefully to apply Clark model proposed in this study.

• Korean Journal of Ecology and Environment
• /
• v.46 no.1
• /
• pp.94-102
• /
• 2013

This study was carried out to determine the variation of the water level and crosssection area for investigating changes of stream foreland, and to determine the correlation between the average flow velocity and cross-section area so as to understand the hydrological characteristics of the stream. The slope of the cross-sectional area was changed in water levels of 0.6~1.0 m and 1.8~2.0 m. The first change occurred in the low-water level season, and the second change occurred in the high-water level seasons. It is assumed that the changes occurred due to the geological transfigure. The correlation between the cross-sectional area and the average flow velocity was 0.22~0.86 in the exponential equation and 0.20~0.87 in the linear equation. The low water level had a higher correlation than the high water level, and free weirs in the upper stream showed a very low correlation. Therefore, this study provides novel information for the management of water quality in the riverside, using correlation equations of the water level and flow velocity with the cross section area.

• Journal of the Korean Electrochemical Society
• /
• v.23 no.4
• /
• pp.105-112
• /
• 2020

Transition metal oxide, which undergoes a conversion reaction in the negative electrode material for a lithium-ion batteries, has a high specific capacity, but still has several critical problems. In this study, manganese pyrophosphate (Mn₂P₂O₇), nickel pyrophosphate (Ni₂P₂O₇), and carbon composite materials with pyrophosphates as novel negative electrode materials instead of transition metal oxide, are synthesized through simple solid-state reaction. The initial reversible capacity of Mn₂P₂O₇ and Ni₂P₂O₇ are 333 and 340 mAh g^-1, and when the composite materials are composed with carbon, the reversible capacity increases to 433 and 387 mAh g^-1, respectively. The initial Coulombic efficiency is also improved by about 10%. The Mn₂P₂O₇ and carbon composite material has the highest initial capacity and efficiency, and has the best cycle performance. Mn₂P₂O₇ containing polyanion, has a lower specific capacity due to the large mass of polyanion compared to MnO (manganese oxide). However, since Mn₂P₂O₇ shows a voltage curve with a slope, the charging (lithiation) voltage increases from 0.51 to 0.57 V (vs. Li/Li⁺), and the discharge (delithiation) voltage decreases from 1.15 to 1.01 V (vs. Li/Li⁺). Therefore, the voltage efficiency of the cell is improved because the voltage difference between charging and discharging is greatly reduced from 0.64 to 0.44 V, and the operating voltage of the full cell increases because the negative electrode potential is lowered during the discharging process.