• Title/Summary/Keyword: General ventilation

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The Work and Job Satisfaction of Paramedics in the Emergency Room of University Hospitals (대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도)

  • Lee, Ok-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.47-63
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    • 2011
  • Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

A Study of Acute Gastroenteritis in Neonates Transfered from Postpartum Care Centers (산후조리원에서 전원되어 입원한 신생아 급성 장염 환자들에 대한 임상적 고찰)

  • Kim, Jong Suh;Lee, Hae Sung;Choi, Jung Hwan;Shin, Yoon Jung;Koo, Mi Lim;Kim, Sung Sin;Kim, Heui Suck;Kim, Eun Ah;Yoon, Sin Won;Kwon, Jae Hoon;Yoon, Sin Won;Kim, Jong Hoon;Sin, Sun Heui;Koo, Sung Kyung;Yang, Sung;Yoo, Sin;Ahn, Young Min;Kim, Eun Mi;Lee, Dong Hwan
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.186-192
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    • 2003
  • Purposes : Recently, acute gastroenteritis broke out among the neonates transferred from postpartum care centers located in Seoul, and Gyeounggi area. Thus, we researched the cause, progress and characters of the disease by analyzing the cases from 9 hospitals in Seoul and Gyeounggi area. Methods : We conducted retrospective study of 33 neonates transferred from postpartum care centers from October 2001 to July 2002 : we divided the neonates into 2 groups. The severe group had any of following 5 conditions : blood pH <7.20, respiratory difficulty, mechanical ventilation, shock, and disseminated intravascular coagulation. And the rest were classified into the moderate group. Results : The severe group was significantly more aged than the moderate group(P= 0.005). Weight loss was significantly severe in the severe group(P=0.0512). In blood gas analysis, bicarbonate was less in the severe group than the moderate group(P=0.032). In the virus examination, rotavirus was detected in 7 cases, and astrovirus was detected in 1 case. In the severe group, 4 neonates were dead. Conclusion : In acute gastroenteritis of neonates, early diagnosis and treatment are important. Thus, the legislation of postpartum care center is needed, and the medical specialists should be stationed in postpartum care center. We assume that the severe group had severe conditions because they were treated comparatively late. However, to find out the cause of the disease and to cope with it, the nationwide epidemiologic study on acute gastrenteritis of neonates is needed.

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Video Assisted Thoracoscopic Sympathetic Ramus Clipping in Essential Hyperhidrosis -Cadaver Fitting Test and Clinical Application (다한증 환자에서 클립을 이용한 교감신경 교통가지 차단술 -사체 연구 및 임상적용-)

  • Lee, Sung-Ho;Cho, Seong-Joon;Jung, Jae-Seung;Kim, Tae-Sik;Son, Ho-Sung;Sun, Kyung;Kim, Kwang-Taik;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.595-601
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    • 2003
  • Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.

A Study on Necessity and Demands of Teachers and Students for Housing Contents in Technology.Home Economics Curriculum of the Middle School (중학교 기술.가정 교과의 주생활 영역 교과내용에 대한 교사와 학생의 필요성 및 요구도 -울산광역시를 중심으로-)

  • Choi, Hye-Mi;Kim, Sun-Joong
    • Journal of Korean Home Economics Education Association
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    • v.19 no.4
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    • pp.75-89
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    • 2007
  • This study has its aim at suggesting new direction of our education to search different ways in housing contents by comparing the necessity perception and demands between teachers and students for housing contents in Technology Home Economics curriculum of middle school. To achieve this aim, I chose middle school teachers in charge of Technology Home Economics and male and female students who are in the first grade in high school in Ulsan. I sent e-mail, mail, and visited researcher to gather the data. I used SPSS +12 statistical package for frequency, percentage, mean, standard deviation, and t-test to analyze the data. Here is the result. First, In the part of application of living place, teachers had necessity perception in use and placement of furniture, and arrangement of objects. Students had necessity perception in the use and placement of furniture, the kind and choice of furniture. Also in the indoor environment and equipment part, both teachers and students had necessity perception in controlling of ventilation, temperature, and humidity. In the part of maintenance repair of housing, teachers had necessity perception in the need for maintenance management but students had necessity perception in house equipments and repair had high necessity perception Second, In housing-related general part, teachers demanded housing for elderly, disabled people, information about future housing and students demanded environmentally friendly living environment, housing for elderly, disabled people. In interior design part, teachers demanded in the expression of interior places through computer, the kind and characteristic of housing material and students demanded the way to reuse old furniture, kind and characteristic of housing material. In the part of housing preparation and occupation, teachers demanded the kind of housing-related occupation and students demanded the housing tax and the process of house purchase or concerned matter. Third, there were some difference of necessity perception and degree of demand between teachers and students. Teachers had higher necessity perception and demand in all part except in demand for housing equipment, maintenance, and environmentally friendly living environment.

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The Study of Effectiveness of MERS on the Law and Remaining Task (국내 메르스(MERS) 사태가 남긴 과제와 법률에 미친 영향에 대한 소고(小考))

  • Yoon, Jong Tae
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.263-291
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    • 2015
  • In May, 2015, a 68 years old man, who has been Middle East Saudi Arabia and the United Arab Emirates, had high fever, muscle aches, cough and shortness of breath. he went two local hospital near his house and the S Medical Center emergency center. He was diagnosed MERS(Middle East respiratory syndrome) and the diseases had put South Korea the fear of epidemics for three months. Especially, this disease has firstly reported in Middle East Asia in September 2012 and spreaded to twenty-six countries. In 21, July, 2015, European Center for disease prevention and control reported 533 people were died and in South Korea, 186 people were infected, 36 people were died and 16,693 people were isolated from MERS. South Korea government were faced into epidemic control and blamed from public. Especially, hospital acquired infection, disease control chain, opening of information, ventilation, lack of isolation bed, the problem of function of local health center, the issue of reparation for hospital and insurance cover rate, the classification of disease, the role of Korea Centers for disease control and prevention, the culture of visiting hospital to see sick people, the issue of hospital multiple room and other related social support policy. it is time to study and discuss to solve these problems. South Korea citizens felt fear and fright from MERS. What is wore, they thought the dieses were out of their government control. It was unusual case for word except Middle East Asia. numerous tourists canceled visiting korea. South korea economic were severly damaged especially, tourism industry. South korea government should admit that they had failed initial action against MERS and take full reasonability from any damages. The government have to open information to public in terms of epidemic diseases and try to prevent any other epidemic diseases and try to work with local governments.

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A research on the introducing the waterproof corrugated cardboard box for the efficient shipment of chinese cabbages and radishes: Focusing on Garak-dong wholesale market as the center

  • Lee, Rae-Hyup;Sun, Il-Suck
    • Asian Journal of Business Environment
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    • v.2 no.1
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    • pp.25-34
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    • 2012
  • It is possible to use pallet for forwarding as chinese cabbages and radishes are general large-scale trading items at the agricultural wholesale market though, however, most of these are forwarded as it have packed in net bags or in P·E bags. Thus, it is still hard for palletizing. The type of packing the product in the net bag makes it difficult for palletizing. It is not a stable shape enough and easily collapsed for pallet loading. Because of this collapsibility, the corrugated cardboard box is being used to enhance forwarding efficiency, but the existing corrugated cardboard box could be crushed easily by moist what is from the agricultural product's property and it also could be squashed by the mass of the loaded box layers on itself. In contrary, the functional waterproof corrugated cardboard box is not collapsed through palletizing and it is efficient for product management with it's ventilation function in respond to pre-cooling effect. Furthermore, because it has various functional shapes as the open type, the partition type and so on, it is effective for maintaining freshness of the product and standardizing the distribution of agricultural product. It is well-known that it is possible to introduce this box to cargo-works of agricultural product. Consequently, the recognition of main distributors about the pallet distribution of the chinese cabbage and the radish was apprehended in this study for activating mechanization of loading and unloading. The survey was conducted to the main distributors such as the forwarder, the auction dealer and the commission merchant with Garak-dong wholesale market as the center. The appropriate packing materials and problems of the existing method for loading and unloading were derived through the survey. Especially, it was focused on analyzing the difference of recognition between the subject groups for the way of using waterproof cardboard corrugated box to deal with the difficult product for packing in normal corrugated box because of the box's absorption of moist from the agricultural product like a chinese cabbage and a radish. Total In the cases of the forwarders and the commission merchants, the net was highly responded as 45%, 74% from each groups for the best packing material for mechanization of distribution and the waterproof corrugated cardboard box was responded as 20%, 22% from each groups as much preferable than multi-stage wooden box. However, for the radish, the waterproof corrugated cardboard box was the best material as 56%, and the auction trader group supported it for 80%. So, the using the waterproof corrugated cardboard box for mechanization of distribution was negative for the chinese cabbage, but it was positive for the radish. The average was 2.42, the standard deviation was 1.24. The negative response(about 55%) was prevailing more than positive response(about 23%). It could be analyzed that even there was the positive recognition for using the waterproof corrugated cardboard box for the radish though the preference for low price of net bag in the chinese cabbage forwarding procedure. Still now, it seems that is a burden for using the waterproof corrugated cardboard box with high price. In the analysis on the recognition differences about using the waterproof corrugated cardboard box for the chinese cabbages and the radish between the forwarders and the commission merchants, generally the negative recognition was prevailing, but the forwarders(2.696) were more positive for using the waterproof corrugated cardboard box than the commission merchants(2.145).

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Changes in Tomato Growth and Productivity under Different Night Air Temperatures (야간온도에 따른 토마토 생육 및 생산성 변화)

  • Kang, Yun-Im;Kwon, Joon-Kuk;Park, Kyoung-Sub;Choi, Gyeong-Lee;Roh, Mi-Young;Cho, Myeong-Whan;Kim, Dae-Young;Kang, Nam-Jun
    • Journal of agriculture & life science
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    • v.46 no.6
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    • pp.25-31
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    • 2012
  • This study aimed to investigate the effect of night temperature on the productivity, growth, and fruit characteristics of tomatoes and set the optimal night air temperature. Tomatoes (Solanum lycopersicum Mill. cv. Superdoterang and cv. Rapito) were grown at 5, 10, 15, and $20^{\circ}C$ during night time and ventilation temperature point during day time set $27^{\circ}C$. Depending on night air temperature, plant height, leaf area, fresh and dry weight of each organ, leaf, stem, and root were changed. Condition of high night temperature resulted in promotion of tomatoes growth with high dry weight and fresh weight. However, the dry weight under night temperature $20^{\circ}C$ decreased, especially, in 'Superdoterang'. On changes of yield, 'Rapito' showed higher productivity than 'Superdoterang' and the highest productivity point for nigh temperature is $13.32^{\circ}C$ for 'Superdoterang' and $14.25^{\circ}C$ for 'Rapito'. Although the total yield decreased from the point, the daily productivity increased with increasing night temperature, the highest point for nigh temperature is $14.45^{\circ}C$ for 'Superdoterang' and $16.46^{\circ}C$ for 'Rapito'. High temperature deceased the fruit weight and increased total soluble solid content in fruits. It is concluded that the night air temperature changes productivity of tomato and the temperatures between productivity and growth velocity have differences depending on different cultivars. scores than the other beef jerky samples (p<0.05).

Analysis of Spatial and Vertical Variability of Environmental Parameters in a Greenhouse and Comparison of Carbon Dioxide Concentration in Two Different Types of Greenhouses (온실 환경요인의 공간적 및 수직적 특성 분석과 온실 종류에 따른 이산화탄소 농도 비교)

  • Jeong, Young Ae;Jang, Dong Cheol;Kwon, Jin Kyung;Kim, Dae Hyun;Choi, Eun Young
    • Journal of Bio-Environment Control
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    • v.31 no.3
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    • pp.221-229
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    • 2022
  • This study was aimed to investigate spatial and vertical characteristics of greenhouse environments according to the location of the environmental sensors, and to investigate the correlations between temperature, light intensity, and carbon dioxide (CO2) concentration according to the type of greenhouse. Temperature, relative humidity (RH), CO2, and light sensors were installed in the four-different vertical positions of the whole canopy as well as ground and roof space at the five spatial locations of the Venlo greenhouse. Also, correlations between temperature, light intensity, and CO2 concentration in Venlo and semi-closed greenhouses were analyzed using the Curve Expert Professional program. The deviations among the spatial locations were larger in the CO2 concentration than other environmental factors in the Venlo greenhouse. The average CO2 concentration ranged from 465 to 761 µmol·mol-1 with the highest value (646 µmol·mol-1) at the Middle End (4ME) close to the main pipe (50Ø) of the liquefied CO2 gas supply and lowest (436 µmol·mol-1) at the Left Middle (5LM). The deviation among the vertical positions was greater in temperature and relative humidity than other environments. The time zone with the largest deviation in average temperature was 2 p.m. with the highest temperature (26.51℃) at the Upper Air (UA) and the lowest temperature (25.62℃) at the Lower Canopy (LC). The time zone with the largest deviation in average RH was 1 p.m. with the highest RH (76.90%) at the LC and the lowest RH (71.74%) at the UA. The highest average CO2 concentration at each hour was Roof Air (RF) and Ground (GD). The coefficient of correlations between temperature, light intensity, and CO2 concentration were 0.07 for semi-closed greenhouse and 0.66 for Venlo greenhouse. All the results indicate that while the CO2 concentration in the greenhouse needs to be analyzed in the spatial locations, temperature and humidity needs to be analyzed in the vertical positions of canopy. The target CO2 fertilization concentration for the semi-closed greenhouse with low ventilation rate should be different from that of general greenhouses.

Transition of Rice Culture Practices during Chosun Dynasty through Old References IV. Preparation of Seeds and Land (주요 고농서를 통한 조성시대의 도작기술 발전 과정 영구 IV. 조선시대의 비곡종 및 경지관리)

  • Lee, Sung-Kyum;Guh, Ja-Ok;Lee, Eun-Woong;Lee, Hong-Suk
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.36 no.6
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    • pp.576-585
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    • 1991
  • General procedures of seed preparation as conventional guide had been established in China before most of Korean literature documented them. ‘Chwijongbeob’ (method of seed select) was to select good quality of seeds and to discard the rest. In ‘Seonjongbeob’ (method of seed grading) although China employed only ‘Sooseonbeob’ (method of seed select with water), but seeds were selected in order of selection of seeds by winds, selection of seeds by sieve and selection of seed with water in Korea. As compared with the recent techniques, those methods were perfect techniques for selection of good quality seeds of rice, except for method of seed selection by salt water was developed. The method for measurement of seed moisture, and for measurement of melted snow, spoiled urine and extracted juice by boiling water with the bone of livestock were originated from ancient China. The farming books in Korea were more or less followed the above methods. However, these techniques were complicated and impractical interms of validity and rationality. Also, it is judged that these tchniques are more appropriate in dry areas and alkaline soil of China rather than in Korean conditions. The plowing is a work to begin farming, and is operated for air ventilation between atmosphere and earth. Also, this techniques was adopted in the farming books from the early to the late Chosun dynasty without changes. Fields were deep-plowed in the first, in fall (or in spring) and for cultivation, and were shallow -plowed in the second, in spring (or in summer) and in intertillage. The former was for water reserve and land preparation, and the later was for weed control with intertillage. However, plowing in fall which was different from fallowing in dry areas, was recommended in Korea (Jikseol). but was not practiced in Sejongsilrok. This was changed with time, and plowing for cultivation in Korea was interrelated with use of green manure crops, method of plowing of upseting plough, method of manure practice and sometimes dry plowing. In addition, until the 15th century method of using a kind of plowing-tool made of log as farm tools was created to support reclamation for enlargement of farm land in mountaineous and coastal areas. For desolate farm lands by many internal and external disturbances, one tried to recover yield ability by increasing labor productivity from the 17th or 18th century. To do this, ‘Banjongbeob’ (culture method by upset plowing weed control) and ‘Hwanubeob’(culture method by firing weed control) which were cultural methods of ancient China were readapoted but the results were not clearly informed. Also, the reality of those was reexamined in the end of the Chosun dynasty.

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Comparison of Single-Breath and Intra-Breath Method in Measuring Diffusing Capacity for Carbon Monoxide of the Lung (일산화탄소 폐확산능검사에서 단회호흡법과 호흡내검사법의 비교)

  • Lee, Jae-Ho;Chung, Hee-Soon;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.555-568
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    • 1995
  • Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

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