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An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.2 no.1
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    • pp.1-16
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    • 2014
  • Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

Benchmark Results of a Monte Carlo Treatment Planning system (몬데카를로 기반 치료계획시스템의 성능평가)

  • Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.13 no.3
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    • pp.149-155
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    • 2002
  • Recent advances in radiation transport algorithms, computer hardware performance, and parallel computing make the clinical use of Monte Carlo based dose calculations possible. To compare the speed and accuracies of dose calculations between different developed codes, a benchmark tests were proposed at the XIIth ICCR (International Conference on the use of Computers in Radiation Therapy, Heidelberg, Germany 2000). A Monte Carlo treatment planning comprised of 28 various Intel Pentium CPUs was implemented for routine clinical use. The purpose of this study was to evaluate the performance of our system using the above benchmark tests. The benchmark procedures are comprised of three parts. a) speed of photon beams dose calculation inside a given phantom of 30.5 cm$\times$39.5 cm $\times$ 30 cm deep and filled with 5 ㎣ voxels within 2% statistical uncertainty. b) speed of electron beams dose calculation inside the same phantom as that of the photon beams. c) accuracy of photon and electron beam calculation inside heterogeneous slab phantom compared with the reference results of EGS4/PRESTA calculation. As results of the speed benchmark tests, it took 5.5 minutes to achieve less than 2% statistical uncertainty for 18 MV photon beams. Though the net calculation for electron beams was an order of faster than the photon beam, the overall calculation time was similar to that of photon beam case due to the overhead time to maintain parallel processing. Since our Monte Carlo code is EGSnrc, which is an improved version of EGS4, the accuracy tests of our system showed, as expected, very good agreement with the reference data. In conclusion, our Monte Carlo treatment planning system shows clinically meaningful results. Though other more efficient codes are developed such like MCDOSE and VMC++, BEAMnrc based on EGSnrc code system may be used for routine clinical Monte Carlo treatment planning in conjunction with clustering technique.

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A Study on Effective Management & Administration System for Deluxe Hotel Kitchen in Seoul Area. (관공호텔 조리직무의 분업과 통합에 따른 문제점과 개선방안에 관한 연구)

  • 라영선
    • Culinary science and hospitality research
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    • v.1
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    • pp.57-89
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    • 1995
  • Despite prologed business stagnation of both international and domestic economy, hotel business as well as tourist industry has continuously been keeping growing, owing to increase of surplus income and world flowing population. During recent 4 years, growth rate of yearly mean in domestic hotels reached 9.9% and especially that of the superior class hotels 15.2%. In the composition of domestic tourist hotel's revenue, the earnings of guest rooms form 37.4%, on the other hand those of food & beverage 39.9%. This result is that our hotel business is concentrated on its interest in FOOD & BEVERAGE of which productivity per unit dimension can be increased to an unlimited extent and extent and superior class hotels strengthened in F&B are increasing in comparison with European or American hotels which are focused on guest rooms in their management. For value added rate of F&B is low as compared with increase of their earnings, they are interested in the management techniques which focus on rising the rate. As for the cost of Food & Beverage, personnel expenditure forms 36.5% and the direct materials 31.5%. Therefore how to manage personnel and materials costs which compose as much as 68% of total revenue will greatly affect net profit. We can say that an effective management technique in cost of Food & Beverage is one of the most important know-hows in hotel management. Especially management know-how for the Kitchen Department where the most of foods come out makes a great effects on various expenses, productivity and it is the achievement from hotel management. For the most of the hotel's top managers, they don't seriously take the fact that KITCHEN SYSTEM affects greatly total expenditure. This study starts from the point of recognizing the question of fundamental cause affecting tow largest cost elements incurred in Food & Beverage and trying to present an effective kitchen system. To settle the questions raised, I compared and analyzed productivity and cost of food & beverage and unit kitchen centered around superior class hotels in Seoul, which vary in Kitchen Systems. In order to attain the aforementioned study effectively purpose of this study, I compared Room-Service and Coffee-Shop Menu, flow of basic food in the kitchen, extent and result of division of labor and integration in the kitchen, scale of outlet kitchen, productivity, the turnover rate of food in store, food cost rate one another which all vary in Kitchen Systems. All these elements are compared and analyzed each other being divided into two main groups such as①. Main Production kitchen and Banquet Kitchen, and ②. coffee-shop kitchen and Room-service Kitchen. Therefore this study is to point out the problems in managing kitchens of superior class hotels which are different in systems. An effort was made to find out the better Kitchen System for superior deluxe hotels. I emphasize the followings on the proper scale of division of labor and integration of unit kitchen and a disposition plan for outlet kitchens of restaurant. First, KITCHEN SYSTEM as a sub-system of Hotel Management System is composed of sub-systems of outlet unit kitchen. Basic food materials are cooked and served for the guests while support kitchen and out restaurant kitchen interact organically each other. So Kitchen should be considered as a system composed of integrated sub-systems. Second, support and banquet kitchens should be integrated to be managed. And these unit kitchens have to be designed to be placed in the back of banquet rooms area. Third, coffee-shop kitchen and room-service kitchen should be integrated to be managed. Fourth, several unit business kitchens should be place on the same floor. Fifth, main production kitchens ought to be located near the loading duck, food store and large refrigerator. Sixth, considering the limits of supervision, duties should be adjusted as 12-20 cooks in two shifts a day for a sub-kitchen, and 18-30 cooks in three shifts a day so that labor division can be made. Last, I would like to two points for direction and task of future study. Firstly, I compare the effective income and increasing costs each other, which are incurred by increasing the use rate of the second processing materials for foods perched outside and through the results. I can find out the better points of the processing production and circulation system, and then I study this effects made on hotel kitchen system. Secondly, I can point out that more efficient kitchen system shall be established through comparing and analyzing the matter of amount of indirect costs and flow of food in different kitchen systems.

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The Limitation of Air Carriers' Cargo and Baggage Liability in International Aviation Law: With Reference to the U.S. Courts' Decisions (국제항공법상 화물.수하물에 대한 운송인의 책임상한제도 - 미국의 판례 분석을 중심으로 -)

  • Moon, Joon-Jo
    • The Korean Journal of Air & Space Law and Policy
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    • v.22 no.2
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    • pp.109-133
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    • 2007
  • The legal labyrinth through which we have just walked is one in which even a highly proficient lawyer could easily become lost. Warsaw Convention's original objective of uniformity of private international aviation liability law has been eroded as the world community ha attempted again to address perceived problems. Efforts to create simplicity and certainty of recovery actually may have created less of both. In any particular case, the issue of which international convention, intercarrier agreement or national law to apply will likely be inconsistent with other decisions. The law has evolved faster for some nations, and slower for others. Under the Warsaw Convention of 1929, strict liability is imposed on the air carrier for damage, loss, or destruction of cargo, luggage, or goods sustained either: (1) during carriage in air, which is comprised of the period during which cargo is 'in charge of the carrier (a) within an aerodrome, (b) on board the aircraft, or (c) in any place if the aircraft lands outside an aerodrome; or (2) as a result of delay. By 2007, 151 nations had ratified the original Warsaw Convention, 136 nations had ratified the Hague Protocol, 84 had ratified the Guadalajara Protocol, and 53 nations had ratified Montreal Protocol No.4, all of which have entered into force. In November 2003, the Montreal Convention of 1999 entered into force. Several airlines have embraced the Montreal Agreement or the IATA Intercarrier Agreements. Only seven nations had ratified the moribund Guatemala City Protocol. Meanwhile, the highly influential U.S. Second Circuit has rendered an opinion that no treaty on the subject was in force at all unless both affected nations had ratified the identical convention, leaving some cases to fall between the cracks into the arena of common law. Moreover, in the United States, a surface transportation movement prior or subsequent to the air movement may, depending upon the facts, be subject to Warsaw, or to common law. At present, International private air law regime can be described as a "situation of utter chaos" in which "even legal advisers and judges are confused." The net result of this barnacle-like layering of international and domestic rules, standards, agreements, and criteria in the elimination of legal simplicity and the substitution in its stead of complexity and commercial uncertainty, which manifestly can not inure to the efficient and economical flow of world trade. All this makes a strong case for universal ratification of the Montreal Convention, which will supersede the Warsaw Convention and its various reformulations. Now that the Montreal Convention has entered into force, the insurance community may press the airlines to embrace it, which in turn may encourage the world's governments to ratify it. Under the Montreal Convention, the common law defence is available to the carrier even when it was not the sole cause of the loss or damage, again making way for the application of comparative fault principle. Hopefully, the recent entry into force of the Montreal Convention of 1999 will re-establish the international legal uniformity the Warsaw Convention of 1929 sought to achieve, though far a transitional period at least, the courts of different nations will be applying different legal regimes.

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