• Title/Summary/Keyword: EXTENSIVE MANAGEMENT

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Appendiceal Visualization on 2-mSv CT vs. Conventional-Dose CT in Adolescents and Young Adults with Suspected Appendicitis: An Analysis of Large Pragmatic Randomized Trial Data

  • Jungheum Cho;Youngjune Kim;Seungjae Lee;Hooney Daniel Min;Yousun Ko;Choong Guen Chee;Hae Young Kim;Ji Hoon Park;Kyoung Ho Lee;LOCAT Group
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.413-425
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    • 2022
  • Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15-44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.

Analyzing the Impact of Multivariate Inputs on Deep Learning-Based Reservoir Level Prediction and Approaches for Mid to Long-Term Forecasting (다변량 입력이 딥러닝 기반 저수율 예측에 미치는 영향 분석과 중장기 예측 방안)

  • Hyeseung Park;Jongwook Yoon;Hojun Lee;Hyunho Yang
    • The Transactions of the Korea Information Processing Society
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    • v.13 no.4
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    • pp.199-207
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    • 2024
  • Local reservoirs are crucial sources for agricultural water supply, necessitating stable water level management to prepare for extreme climate conditions such as droughts. Water level prediction is significantly influenced by local climate characteristics, such as localized rainfall, as well as seasonal factors including cropping times, making it essential to understand the correlation between input and output data as much as selecting an appropriate prediction model. In this study, extensive multivariate data from over 400 reservoirs in Jeollabuk-do from 1991 to 2022 was utilized to train and validate a water level prediction model that comprehensively reflects the complex hydrological and climatological environmental factors of each reservoir, and to analyze the impact of each input feature on the prediction performance of water levels. Instead of focusing on improvements in water level performance through neural network structures, the study adopts a basic Feedforward Neural Network composed of fully connected layers, batch normalization, dropout, and activation functions, focusing on the correlation between multivariate input data and prediction performance. Additionally, most existing studies only present short-term prediction performance on a daily basis, which is not suitable for practical environments that require medium to long-term predictions, such as 10 days or a month. Therefore, this study measured the water level prediction performance up to one month ahead through a recursive method that uses daily prediction values as the next input. The experiment identified performance changes according to the prediction period and analyzed the impact of each input feature on the overall performance based on an Ablation study.

Domain Knowledge Incorporated Local Rule-based Explanation for ML-based Bankruptcy Prediction Model (머신러닝 기반 부도예측모형에서 로컬영역의 도메인 지식 통합 규칙 기반 설명 방법)

  • Soo Hyun Cho;Kyung-shik Shin
    • Information Systems Review
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    • v.24 no.1
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    • pp.105-123
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    • 2022
  • Thanks to the remarkable success of Artificial Intelligence (A.I.) techniques, a new possibility for its application on the real-world problem has begun. One of the prominent applications is the bankruptcy prediction model as it is often used as a basic knowledge base for credit scoring models in the financial industry. As a result, there has been extensive research on how to improve the prediction accuracy of the model. However, despite its impressive performance, it is difficult to implement machine learning (ML)-based models due to its intrinsic trait of obscurity, especially when the field requires or values an explanation about the result obtained by the model. The financial domain is one of the areas where explanation matters to stakeholders such as domain experts and customers. In this paper, we propose a novel approach to incorporate financial domain knowledge into local rule generation to provide explanations for the bankruptcy prediction model at instance level. The result shows the proposed method successfully selects and classifies the extracted rules based on the feasibility and information they convey to the users.

Factors Affecting the Intention to Adopt Self-Determination Rights of Personal Medical Information (개인의료정보 자기결정권 행사 의도에 영향을 미치는 요인)

  • Yunmo Koo;Sungwoo Hong;Beomsoo Kim
    • Information Systems Review
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    • v.20 no.1
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    • pp.159-177
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    • 2018
  • With an extensive proliferation of information and communication technology, the volume and amount of digital information collected and utilized on the Internet have been increasing rapidly. Also on the rapid rise are side effects such as unintended breach of accumulated personal information and consequent invasion of personal privacy. Informational self-determination is rarely practiced, despite various states' legal efforts to redress data subjects' damage. Personal health information, in particular, is a subcategory of personal information where informational self-determination is hardly practiced enough. The observation is contrasted with the socio-economic inconvenience that may follow due to its sensitive nature containing individuals' physical and health conditions. This research, therefore, reviews factors of self-determination on personal health information while referring to the protection motivation theory (PMT), the long-time framework to understand personal information protection. Empirical analysis of 200 data surveyed reveals threat-appraisal (perceived vulnerability and perceived severity of threats) and coping-appraisal (perceived response effectiveness), in addition to individual levels of concern regarding provided personal health information, influence self-determination to protect personal health information. The research proposes theoretical findings and practical suggestions along with reference for future research topics.

Examination of Soil Contamination Status and Improvement Strategies within Urban Development Projects (도시개발사업 내 토양 오염 현황과 개선 방안 고찰)

  • Heo, Sujung;Lee, Dong-Kun;Kim, Eunsub;Jeon, Seong-Woo;Jin, Zhiying
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.27 no.3
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    • pp.45-56
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    • 2024
  • Heavy metals emitted from urban development do not decompose in the soil and remain for long periods, continually impacting the environment. Since the mid-1990s, there has been increasing societal concern in South Korea regarding soil contamination, prompting various legislative revisions to reduce pollution. This study utilizes the Environmental Impact Assessment Support System (EIASS) to investigate projects in the metropolitan area that have exceeded the Ministry of Environment's soil contamination concern levels from 1989 to 2022 and to examine improvements in the environmental impact assessment (EIA) process. The results reveal that the average concentrations of nine contaminants-cadmium (Cd), copper (Cu), arsenic (As), mercury (Hg), lead (Pb), hexavalent chromium (Cr6+), zinc (Zn), nickel (Ni), and fluoride (F)-have all increased over the years. Among these, Zn had the highest relative proportion, with 37.5% of the 40 sites exceeding environmental concern levels. Investigation of 19 specific projects at these exceedance sites showed that only 7 had documented analyses of contamination causes and remediation plans, and just one had contracted additional remediation services, though results from these efforts were found to be lacking. Furthermore, since 2019, a significant proportion of these sites were involved in residential developments, likely due to government initiatives in new city development and extensive housing supply plans. This research emphasizes the importance of public disclosure of the processes and outcomes of remediation efforts on historically contaminated soils prior to project development. It discusses improvements to the EIA by reviewing current legislation and international examples. The findings of this study are expected to heighten public awareness about heavy metal contamination and enhance transparency in soil remediation efforts, contributing to sustainable environmental management and development.

Bovine mastitis-associated Escherichia coli

  • Hong Qui Le;Se Kye Kim;Jang Won Yoon
    • Journal of Food Hygiene and Safety
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    • v.39 no.3
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    • pp.181-190
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    • 2024
  • Bovine mastitis-associated Escherichia coli (BMEC) is considered the main causative agent of significant financial losses in the dairy industry worldwide, as it alters both the quantity and quality of milk produced and increases the rate of culling. This creates a variety of challenges for researchers, veterinarians, and farmers in understanding and determining the most effective therapies and diagnostic techniques. Subclinical mastitis is particularly concerning, as infected bovines exhibit no obvious symptoms and continue to secrete apparently normal milk over an extended period, allowing the causative pathogen, E. coli, to spread within the herd. For effective prevention, understanding the pathogenesis of mastitis through three stages invasion, infection, and inflammation is essential. To date, no clear correlation has been found between virulence factors and pathogenicity contributing to the clinical severity of BMEC. Multidrug-resistant E. coli and the evolution of novel resistance mechanisms have become concerns owing to the extensive use of antibiotics to treat mastitis. Therefore, it is vital to explore alternative controls to enhance the efficacy of BMEC treatment. Over the past 30 years, various genetic typing techniques have been used to examine the subspecies-level epidemiology of bovine mastitis. These studies have advanced our understanding of the origin, transmission pathway, population structure, and evolutionary relatedness of BMEC strains. In this review we provide an overview of BMEC, including insights into its etiology, genetic relationship, pathogenesis, and management of the disease, as well as new therapy options.

A Study on University Students' Business Planning and Starting up a Business in Korea (우리나라 대학생들의 창업 및 사업계획에 대한 연구)

  • Koh, In-Kon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.2
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    • pp.1-8
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    • 2012
  • Recently the youth starting up a business has become a buzzword. Business plan is a fundamentals in starting up a business. Therefore, in this study, I investigated the business planning behavior of university students in Korea. Especially, I investigated whether university students in Korea dealt with business plan inside and outside or not, and examined university students' thought whether corporate performance is related to business plan or not, and if any, how closely they are. Meanwhile, existing studies and books are arguing that there is a high correlation between business plan and corporate performance, however, there are not many domestic and/or foreign studies that analyzed it empirically. In order to find an answer to this problem, this study was approached empirically. First, the components of business plan were selected through an extensive literature review including existing researches and through factor analysis, I classified them into the five factors of product management, product development, management support system building, organizational management and macro planning. Also, I classified corporate performance into quantitative and qualitative performance, and investigated the influences of business plan factors on those performances. As a result, I found belows. First, university students in Korea thought that the business plan components affected the quantitative and qualitative performances of corporate positively. Second, Korean students had high interests in starting up a business and wanted to run a service business but had almost no experience of business planning. Whilst, Foreign students had relatively high interests in starting up a business and experiences of business planning. They wanted starting up in various industry also. Meanwhile, I did't find the gender differences in those aspects. In this study, I empirically investigated the relation between business plan components and corporate performances in the university students' view, not that of company. So I believe that this study can shed lights on the direction of effective starting up education for increasing the success rate of youth starting up a business.

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Classification System of Wetland Ecosystem and Its Application (습지생태계 분류체계의 검토 및 적용방안 연구)

  • Chun, Seung Hoon;Lee, Byung Hee;Lee, Sang Don;Lee, Yong Tae
    • Journal of Wetlands Research
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    • v.6 no.3
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    • pp.55-70
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    • 2004
  • The wetland ecosystem is a complex products of various erosion force, accumulation as water flows, hydrogeomorphic units, seasonal changes, the amount of rainfalls, and other essential element. There is no single, correct, ecologically sound definition for wetlands because of the diversity of wetlands and the demarcation between dry and wet environments occurs along a continuum, but wetland plays various ecosystem functions. Despite comprehensive integration through classification and impact factors there is still lacking in systematic management of wetlands. Classification system developed by the USFWS(1979) is hierarchical progresses from systems and subsystems at general levels to classes, subclasses, dominance types, and habitat modifiers. Systems and subsystems are delineated according to major physical attributes such as tidal flushing, ocean-derived salts, and the energy of flowing water or waves. Classes and subclasses describe the type of substrate and habitat or the physiognomy of the vegetation or faunal assemblage. Wetland classes are divided into physical types and biotic types. For the wise management of wetlands in Korea, this study was carried out to examine methodology of USFWS classification system and discuss its application for Korean wetland hydrogeomorphic units already known. Seven wetland types were chosen as study sites in Korea divided into some different types based on USFWS system. Three wetland types belonging to palustrine system showed no difference between Wangdungjae wetland and Mujechi wetland, but Youngnup of Mt. Daeam was different from the former two types at the level of dominant types. This fact means that setting of classification system for management of wetland is needed. Although we may never know much about the wetland resources that have been lost, there are opportunities to conserve the riches that remain. Extensive inventory of all wetland types and documentation of their ecosystem functions are vital. Unique and vulnerable examples in particular need to be identified and protected. Furthermore, a framework with which to demonstrate wetland characteristics and relationships is needed that is sufficiently detailed to achieve the identification of the integrity and salient features of an enormous range of wetland types.

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Development and Effectiveness of the Primary Hospice Education Program for Nurses (간호사를 위한 호스피스 기초 교육 프로그램 및 효과)

  • In, Sook-Jin
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2004.07a
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    • pp.100-102
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    • 2004
  • Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

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Adaptive Lock Escalation in Database Management Systems (데이타베이스 관리 시스템에서의 적응형 로크 상승)

  • Chang, Ji-Woong;Lee, Young-Koo;Whang, Kyu-Young;Yang, Jae-Heon
    • Journal of KIISE:Databases
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    • v.28 no.4
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    • pp.742-757
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    • 2001
  • Since database management systems(DBMSS) have limited lock resources, transactions requesting locks beyond the limit mutt be aborted. In the worst carte, if such transactions are aborted repeatedly, the DBMS can become paralyzed, i.e., transaction execute but cannot commit. Lock escalation is considered a solution to this problem. However, existing lock escalation methods do not provide a complete solution. In this paper, we prognose a new lock escalation method, adaptive lock escalation, that selves most of the problems. First, we propose a general model for lock escalation and present the concept of the unescalatable look, which is the major cause making the transactions to abort. Second, we propose the notions of semi lock escalation, lock blocking, and selective relief as the mechanisms to control the number of unescalatable locks. We then propose the adaptive lock escalation method using these notions. Adaptive lock escalation reduces needless aborts and guarantees that the DBMS is not paralyzed under excessive lock requests. It also allows graceful degradation of performance under those circumstances. Third, through extensive simulation, we show that adaptive lock escalation outperforms existing lock escalation methods. The results show that, compared to the existing methods, adaptive lock escalation reduces the number of aborts and the average response time, and increases the throughput to a great extent. Especially, it is shown that the number of concurrent transactions can be increased more than 16 ~256 fold. The contribution of this paper is significant in that it has formally analysed the role of lock escalation in lock resource management and identified the detailed underlying mechanisms. Existing lock escalation methods rely on users or system administrator to handle the problems of excessive lock requests. In contrast, adaptive lock escalation releases the users of this responsibility by providing graceful degradation and preventing system paralysis through automatic control of unescalatable locks Thus adaptive lock escalation can contribute to developing self-tuning: DBMSS that draw a lot of attention these days.

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