• Journal of the Korean Society of Radiology
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• v.13 no.1
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• pp.111-118
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• 2019

Chest digital tomosynthesis has become a practical imaging modality because it can solve the problem of anatomy overlapping in conventional chest radiography. However, because of both limited scan angle and finite-size detector, a portion of chest cannot be represented in some or all of the projection. These bring a discontinuity in intensity across the field of view boundaries in the reconstructed slices, which we refer to as the truncation artifacts. The purpose of this study was to reduce truncation artifacts using a weighted normalization approach and to investigate the performance of this approach for our prototype chest digital tomosynthesis system. The system source-to-image distance was 1100 mm, and the center of rotation of X-ray source was located on 100 mm above the detector surface. After obtaining 41 projection views with ${\pm}20^{\circ}$ degrees, tomosynthesis slices were reconstructed with the filtered back projection algorithm. For quantitative evaluation, peak signal to noise ratio and structure similarity index values were evaluated after reconstructing reference image using simulation, and mean value of specific direction values was evaluated using real data. Simulation results showed that the peak signal to noise ratio and structure similarity index was improved respectively. In the case of the experimental results showed that the effect of artifact in the mean value of specific direction of the reconstructed image was reduced. In conclusion, the weighted normalization method improves the quality of image by reducing truncation artifacts. These results suggested that weighted normalization method could improve the image quality of chest digital tomosynthesis.

• Journal of the Korean Society of Radiology
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• v.16 no.1
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• pp.67-75
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• 2022

The aim of this study is to establish a new QC method that can simultaneously evaluate the resolution of the x/y plane and the z-axis by producing a phantom that can reflect exposure and reconstruction parameter of MDCT system. It was used with Aquilion ONE(Cannon Medical System, Otawara, Japan), and the examination was scanned using of 120 kV, 260 mA, and the D-FOV of 300 mm². It produced new SSP phantom modules in which two aluminum plates inclined at 45° to a vertical axis and a transverse axis to evaluate high contrast resolution of x/y plane and z axis. And it changed factors such as the algorithm, distance from gantry iso-center. All images were reconstructed in five steps from 0.6 mm to 10.0 mm slice thickness to measure resolution of x/y plane and z-axis. The image data measured FWHM and FWTM using Profile tool of Aquarius iNtusion Edition ver. 4.4.13 P6 software(Terarecon, California, USA), and analysed SPQI and signal intensity by ImageJ program(v1.53n, National Institutes of Health, USA). It decreased by 4.09~11.99%, 4.12~35.52%, and 4.70~37.64% in slice thickness of 2.5 mm, 5.0 mm, and 10.0 mm for evaluating the high contrast resolution of x/y plane according to distance from gantry iso-center. Therefore, the high contrast resolution of the x/y plane decreased when the distance from the iso-center increased or the slice thickness increased. Additionally, the slice thicknesses of 2.5 mm, 5.0 mm, and 10.0 mm with a high algorithm increased 74.83, 15.18 and 81.25%. The FWHM was almost constant on the measured SSP graph for evaluating the accuracy of slice thickness which represents the resolution of x/y plane and z-axis, but it was measured to be higher than the nominal slice thickness set by user. The FWHM and FWTM of z-axis with axial scan mode tended to increase significantly as the distance increased from gantry iso-center than the helical mode. Particularly, the thinner slice thickness that increased error range compare with the nominal slice thickness. The SPQI increased with thick slice thickness, and that was closer to 90% in the helical scan than the axial scan. In conclusion, by producing a phantom suitable for MDCT detectors and capable of quantitative resolution evaluation, it can be used as a specific method in the management of research quality and management of outdated equipment. Thus, it is expected to contribute greatly to the discrimination of lesions in the field of CT imaging.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.305-314
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• 2023

With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.

• Korean Journal of Remote Sensing
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• v.39 no.6_1
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• pp.1353-1369
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• 2023

In the event of a disaster accident at sea, the scale of damage will vary due to weather effects such as wind, currents, and tidal waves, and it is obligatory to minimize the scale of damage by establishing appropriate control plans through quick on-site identification. In particular, it is difficult to identify pollutants that exist in a thin film at sea surface due to their relatively low viscosity and surface tension among pollutants discharged into the sea. Therefore, this study aims to develop an algorithm to detect suspended pollutants on the sea surface in RGB images using imaging equipment that can be easily used in the field, and to evaluate the performance of the algorithm using input data obtained from actual waters. The developed algorithm uses image enhancement techniques to improve the contrast between the intensity values of pollutants and general sea surfaces, and through histogram analysis, the background threshold is found,suspended solids other than pollutants are removed, and finally pollutants are classified. In this study, a real sea test using substitute materials was performed to evaluate the performance of the developed algorithm, and most of the suspended marine pollutants were detected, but the false detection area occurred in places with strong waves. However, the detection results are about three times better than the detection method using a single threshold in the existing algorithm. Through the results of this R&D, it is expected to be useful for on-site control response activities by detecting suspended marine pollutants that were difficult to identify with the naked eye at existing sites.

• Korean Journal of Remote Sensing
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• v.39 no.6_1
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• pp.1413-1425
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• 2023

The increasing frequency of wildfires due to climate change is causing extreme loss of life and property. They cause loss of vegetation and affect ecosystem changes depending on their intensity and occurrence. Ecosystem changes, in turn, affect wildfire occurrence, causing secondary damage. Thus, accurate estimation of the areas affected by wildfires is fundamental. Satellite remote sensing is used for forest fire detection because it can rapidly acquire topographic and meteorological information about the affected area after forest fires. In addition, deep learning algorithms such as convolutional neural networks (CNN) and transformer models show high performance for more accurate monitoring of fire-burnt regions. To date, the application of deep learning models has been limited, and there is a scarcity of reports providing quantitative performance evaluations for practical field utilization. Hence, this study emphasizes a comparative analysis, exploring performance enhancements achieved through both model selection and data design. This study examined deep learning models for detecting wildfire-damaged areas using Landsat 8 satellite images in California. Also, we conducted a comprehensive comparison and analysis of the detection performance of multiple models, such as U-Net and High-Resolution Network-Object Contextual Representation (HRNet-OCR). Wildfire-related spectral indices such as normalized difference vegetation index (NDVI) and normalized burn ratio (NBR) were used as input channels for the deep learning models to reflect the degree of vegetation cover and surface moisture content. As a result, the mean intersection over union (mIoU) was 0.831 for U-Net and 0.848 for HRNet-OCR, showing high segmentation performance. The inclusion of spectral indices alongside the base wavelength bands resulted in increased metric values for all combinations, affirming that the augmentation of input data with spectral indices contributes to the refinement of pixels. This study can be applied to other satellite images to build a recovery strategy for fire-burnt areas.

• Korean Journal of Environmental Agriculture
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• v.38 no.4
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• pp.225-236
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• 2019

BACKGROUND: Hydroponics is one of the methods for evaluating plant production using the inorganic nutrient solutions, which is applied under the artificial light conditions of plant factory system. However, the application of the conventional inorganic nutrients for hydroponics caused several environmental problems: waste from culture mediums and high nitrate concentration in plants. Organic nutrients are generally irrigated as a supplementary fertilizer for plant growth promotion under field or greenhouse conditions. Hydroponic culture using organic nutrients derived from the agricultural by-products such as dumped stems, leaves or immature fruits is rarely considered in plant factory system. Effect of organic or conventional inorganic nutrient solutions on the growth and nutrient absorption pattern of green and red leaf lettuces was investigated in this experiment under fluorescent lamps (FL) and mixture Light-Emitting Diodes (LEDs). METHODS AND RESULTS: Single solution of tomatoes (TJ) and kales (K) deriving from agricultural by-products including leaves or stems and its mixed solution (mixture ration 1:1) with conventional inorganic Yamazaki (Y) were supplied for hydroponics under the plant factory system. The Yamazaki solution was considered as a control. 'Jeockchima' and 'Cheongchima' lettuce seedlings (Lactuca sativa L.) were used as plant materials. The seedlings which developed 2~3 true leaves were grown under the light qualities of FL and mixed LED lights of blue plus red plus white of 1:2:1 mixture in energy ratio for 35 days. Light intensity of the light sources was controlled at 180 μmol/㎡/s on the culture bed. The single and mixture nutrient solutions of organic and/or inorganic components which controlled at 1.5 dS/m EC and 5.8 pH were regularly irrigated by the deep flow technique (DFT) system on the culture gutters. Number of unfolded leaves of the seedlings grown under the single or mixed nutrient solutions were significantly increased compared to the conventional Y treatment. Leaf extension of 'Jeockchima' under the mixture LED radiation condition was not affected by Y and YK or YTJ mixture treatments. SPAD value in 'Jeockchima' leaves exposed by FL under the YK mixture medium was approximately 45 % higher than under conventional Y treatment. Otherwise, the maximum SPAD value in the leaves of 'Cheongchima' seedlings was shown in YK treatment under the mixture LED lights. NO₃-N contents in Y treatment treated with inorganic nutrient at the end of the experiment were up to 75% declined rather than increased over 60 % in the K and TJ organic treatment. CONCLUSION: Growth of the seedlings was affected by the mixture treatments of the organic and inorganic solutions, although similar or lower dry weight was recorded than in the inorganic treatment Y under the plant factory system. Treatment Y containing the highest NO₃-N content among the considered nutrients influenced growth increment of the seedlings comparing to the other nutrients. However effect of the higher NO₃-N content in the seedling growth was different according to the light qualities considered in the experiment as shown in leaf expansion, pigmentation or dry weight promotion under the single or mixed nutrients.

• Magazine of the Korean Society of Agricultural Engineers
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• v.11 no.4
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• pp.1775-1782
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• 1969

The results of the study on the consumptine use of irrigated water in paddy fields during the growing season of rice plants are summarized as follows. 1. Transpiration and evaporation from water surface. 1) Amount of transpiration of rice plant increases gradually after transplantation and suddenly increases in the head swelling period and reaches the peak between the end of the head swelling poriod and early period of heading and flowering. (the sixth period for early maturing variety, the seventh period for medium or late maturing varieties), then it decreases gradually after that, for early, medium and late maturing varieties. 2) In the transpiration of rice plants there is hardly any difference among varieties up to the fifth period, but the early maturing variety is the most vigorous in the sixth period, and the late maturing variety is more vigorous than others continuously after the seventh period. 3) The amount of transpiration of the sixth period for early maturing variety of the seventh period for medium and late maturing variety in which transpiration is the most vigorous, is 15% or 16% of the total amount of transpiration through all periods. 4) Transpiration of rice plants must be determined by using transpiration intensity as the standard coefficient of computation of amount of transpiration, because it originates in the physiological action.(Table 7) 5) Transpiration ratio of rice plants is approximately 450 to 480 6) Equations which are able to compute amount of transpiration of each variety up th the heading-flowering peried, in which the amount of transpiration of rice plants is the maximum in this study are as follows: Early maturing variety ; Y=0.658+1.088X Medium maturing variety ; Y=0.780+1.050X Late maturing variety ; Y=0.646+1.091X Y=amount of transpiration ; X=number of period. 7) As we know from figure 1 and 2, correlation between the amount evaporation from water surface in paddy fields and amount of transpiration shows high negative. 8) It is possible to calculate the amount of evaporation from the water surface in the paddy field for varieties used in this study on the base of ratio of it to amount of evaporation by atmometer(Table 11) and Table 10. Also the amount of evaporation from the water surface in the paddy field is to be computed by the following equations until the period in which it is the minimum quantity the sixth period for early maturing variety and the seventh period for medium or late maturing varieties. Early maturing variety ; Y=4.67-0.58X Medium maturing variety ; Y=4.70-0.59X Late maturing variety ; Y=4.71-0.59X Y=amount of evaporation from water surface in the paddy field X=number of period. 9) Changes in the amount of evapo-transpiration of each growing period have the same tendency as transpiration, and the maximum quantity of early maturing variety is in the sixth period and medium or late maturing varieties are in the seventh period. 10) The amount of evapo-transpiration can be calculated on the base of the evapo-transpiration intensity (Table 14) and Tablet 12, for varieties used in this study. Also, it is possible to compute it according to the following equations with in the period of maximum quantity. Early maturing variety ; Y=5.36+0.503X Medium maturing variety ; Y=5.41+0.456X Late maturing variety ; Y=5.80+0.494X Y=amount of evapo-transpiration. X=number of period. 11) Ratios of the total amount of evapo-transpiration to the total amount of evaporation by atmometer through all growing periods, are 1.23 for early maturing variety, 1.25 for medium maturing variety, 1.27 for late maturing variety, respectively. 12) Only air temperature shows high correlation in relation between amount of evapo-transpiration and climatic conditions from the viewpoint of Korean climatic conditions through all growing periods of rice plants. 2. Amount of percolation 1) The amount of percolation for computation of planning water requirment ought to depend on water holding dates. 3. Available rainfall 1) The available rainfall and its coefficient of each period during the growing season of paddy fields are shown in Table 8. 2) The ratio (available coefficient) of available rainfall to the amount of rainfall during the growing season of paddy fields seems to be from 65% to 75% as the standard in Korea. 3) Available rainfall during the growing season of paddy fields in the common year is estimated to be about 550 millimeters. 4. Effects to be influenced upon percolation by transpiration of rice plants. 1) The stronger absorbtive action is, the more the amount of percolation decreases, because absorbtive action of rice plant roots influence upon percolation(Table 21, Table 22) 2) In case of planting of rice plants, there are several entirely different changes in the amount of percolation in the forenoon, at night and in the afternoon during the growing season, that is, is the morning and at night, the amount of percolation increases gradually after transplantation to the peak in the end of July or the early part of August (wast or soil temperature is the highest), and it decreases gradually after that, neverthless, in the afternoon, it decreases gradually after transplantation to be at the minimum in the middle of August, and it increases gradually after that. 3) In spite of the increasing amount of transpiration, the amount of daytime percolation decreases gadually after transplantation and appears to suddenly decrease about head swelling dates or heading-flowering period, but it begins to increase suddenly at the end of August again. 4) Changs of amount of percolation during all growing periods show some variable phenomena, that is, amount of percolation decreases after the end of July, and it increases in end August again, also it decreases after that once more. This phenomena may be influenced complexly from water or soil temperature(night time and forenoon) as absorbtive action of rice plant roots. 5) Correlation between the amount of daytime percolation and the amount of transpiration shows high negative, amount of night percolation is influenced by water or soil temperature, but there is little no influence by transpiration. It is estimated that the amount of a daily percolation is more influenced by of other causes than transpiration. 6) Correlation between the amount of night percoe, lation and water or soil temp tureshows high positive, but there is not any correlation between the amount of forenoon percolation or afternoon percolation and water of soil temperature. 7) There is high positive correlation which is r=+0.8382 between the amount of daily percolation of planting pot of rice plant and amount and amount of daily percolation of non-planting pot. 8) The total amount of percolation through all growin. periods of rice plants may be influenced more from specific permeability of soil, water of soil temperature, and otheres than transpiration of rice plants.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.