• Title/Summary/Keyword: Least Cost

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Trends and Costs of External Electrical Bone Stimulators and Grafting Materials in Anterior Lumbar Interbody Fusion

  • D'Oro, Anthony;Buser, Zorica;Brodke, Darrel Scott;Park, Jong-Beom;Yoon, Sangwook Tim;Youssef, Jim Aimen;Meisel, Hans-Joerg;Radcliff, Kristen Emmanuel;Hsieh, Patrick;Wang, Jeffrey Chun
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.973-980
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    • 2018
  • Study Design: Retrospective review. Purpose: To identify the trends in stimulator use, pair those trends with various grafting materials, and determine the influence of stimulators on the risk of revision surgery. Overview of Literature: A large number of studies has reported beneficial effects of electromagnetic energy in healing long bone fractures. However, there are few clinical studies regarding the use of electrical stimulators in spinal fusion. Methods: We used insurance billing codes to identify patients with lumbar disc degeneration who underwent anterior lumbar interbody fusion (ALIF). Comparisons between patients who did and did not receive electrical stimulators following surgery were performed using logistic regression analysis, chi-square test, and odds ratio (OR) analysis. Results: Approximately 19% of the patients (495/2,613) received external stimulators following ALIF surgery. There was a slight increase in stimulator use from 2008 to 2014 (multi-level $R^2=0.08$, single-level $R^2=0.05$). Patients who underwent multi-level procedures were more likely to receive stimulators than patients who underwent single-level procedures (p<0.05; OR, 3.72; 95% confidence interval, 3.02-4.57). Grafting options associated with most frequent stimulator use were bone marrow aspirates (BMA) plus autograft or allograft for single-level and allograft alone for multi-level procedures. In both cohorts, patients treated with bone morphogenetic proteins were least likely to receive electrical stimulators (p<0.05). Patients who received stimulation generally had higher reimbursements. Concurrent posterior lumbar fusion (PLF) (ALIF+PLF) increased the likelihood of receiving stimulators (p<0.05). Patients who received electrical stimulators had similar revision rates as those who did not receive stimulation (p>0.05), except those in the multilevel ALIF+PLF cohort, wherein the patients who underwent stimulation had higher rates of revision surgery. Conclusions: Concurrent PLF or multi-level procedures increased patients' likelihood of receiving stimulators, however, the presence of comorbidities did not. Patients who received BMA plus autograft or allograft were more likely to receive stimulation. Patients with and without bone stimulators had similar rates of revision surgery.

Study on Estimating Economic Risk Cost of Aids to Navigation Accident in Busan Port, Korea using Contingent Valuation Method (조건부가치측정법을 이용한 부산항 항로표지사고에 대한 항행 위험비용의 추정에 관한 연구)

  • Kim, Tae-Goun;Moon, Beom-Sik
    • Journal of Navigation and Port Research
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    • v.42 no.6
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    • pp.478-485
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    • 2018
  • Aids to Navigation (AtoN) is one of the marine traffic safety facilities that promotes the safety of maritime traffic and enhance ship's operational efficiency. However, functional failure of AtoN due to ship's collision or bad weather conditions leads to inconvenience or navigational risk to various users such as the ship operators. For insstance, the largest container port in Korea, Busan Port has experienced a total of 400 AtoN accidents in the past 12 years (2006-2017).Therefore, an average of 20.6 days of recovery time is required, which increases the maritime safety anxiety for AtoN users. is the objective of this study was to present the quantitative support of the users for the prevention of AtoN accidents and the improvement of the feasibility of implementing more efficient management in Korea. A survey was conducted on the users of Busan port areas to investigate general perception of AtoN in general and the accidents that have happened, and to estimate the economic value of navigational risk reduction by implementing effective AtoN management measure. Using the representative non-market valuation method for environmental or public goods known as contingent valuation method (CVM), the economic value granted to users for the AtoN services in Busan port was estimated to at least 16 billion won. Therefore, these finding could be used by AtoN managers and/or policy makers as a valuable data to identify the users' need of various AtoN services including Busan Port and to establish and implement more efficient management plan.

A Study on the Estimation of the Minimum Buoyancy for the Respiration of a Drowning Person (익수자의 호흡이 가능한 최소 부력 추정에 관한 연구)

  • Yim, Jeong-Bin;Park, Deuk-Jin;Kang, Yu Mi
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.23 no.7
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    • pp.820-828
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    • 2017
  • Tools and equipment that can provide buoyancy for a drowning person are important for saving lives. The purpose of this study was to estimate the minimum amount of gas needed and the buoyancy value in newton units required to generate the minimum buoyancy determined to be sufficient for keeping the head of a drowning person above the water's surface to allow for respiration for at least 1 minute. A buoyancy experiment was carried out with a long rubber balloon injected with carbon dioxide gas, and a buoyancy measurement experiment was performed on six college students. The degree of buoyancy was measured using a 5-point scale, and the statistical value of the measured data was analyzed to estimate minimum buoyancy. As a result, 8 grams of carbon dioxide were determined to satisfy minimum buoyancy conditions with a confidence level of 72%, and buoyancy was calculated to be 44.66 newtons. 12 grams of carbon dioxide met the minimum buoyancy conditions with a confidence level of 100%, and buoyancy was calculated to be 66.99 newtons. This study is expected to contribute to the development of low cost, easy-to-carry minimum buoyancy aids.

The Effect of EU-ETS Introduction on the Determinants of Electricity Net Export Connected Power Grid in Europe (유럽의 탄소배출권 거래시장 도입에 따른 연결계통국가들의 전력 순수출 결정요인 변화 분석)

  • Yoon, Kyungsoo;Park, Changsoo;Cho, Sungbong
    • Environmental and Resource Economics Review
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    • v.28 no.3
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    • pp.385-413
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    • 2019
  • This study examines the determinants of net export of electricity among 30 European countries sharing electricity grid during the period of 1990~2014 by separating the sample period before and after 2005 in which ETS was introduced in Europe. The empirical method used in this study is generalize least squared one considering both heterogeneous and serial correlation in the balanced panel data. According to the empirical results, after 2005 introducing the ETS, holing energy resources, concentrating only on few electricity generation resources, and nuclear electricity generation had played more important role in net export of electricity, while renewable energy had negative effect on net export of electricity and coal and gas generation have no effect on net export after introduction of ETS in Europe probably because of high environmental cost. The policy implication of the results would be that reconsidering each country's optimal generation mix strategy and its role in case freely trading electricity.

Secure Training Support Vector Machine with Partial Sensitive Part

  • Park, Saerom
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.4
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    • pp.1-9
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    • 2021
  • In this paper, we propose a training algorithm of support vector machine (SVM) with a sensitive variable. Although machine learning models enable automatic decision making in the real world applications, regulations prohibit sensitive information from being used to protect privacy. In particular, the privacy protection of the legally protected attributes such as race, gender, and disability is compulsory. We present an efficient least square SVM (LSSVM) training algorithm using a fully homomorphic encryption (FHE) to protect a partial sensitive attribute. Our framework posits that data owner has both non-sensitive attributes and a sensitive attribute while machine learning service provider (MLSP) can get non-sensitive attributes and an encrypted sensitive attribute. As a result, data owner can obtain the encrypted model parameters without exposing their sensitive information to MLSP. In the inference phase, both non-sensitive attributes and a sensitive attribute are encrypted, and all computations should be conducted on encrypted domain. Through the experiments on real data, we identify that our proposed method enables to implement privacy-preserving sensitive LSSVM with FHE that has comparable performance with the original LSSVM algorithm. In addition, we demonstrate that the efficient sensitive LSSVM with FHE significantly improves the computational cost with a small degradation of performance.

Veterans Hospital Medical Expenses Increase & Decrease Characteristics and Convergence Phenomenon-Focusing on the implications of the medical support system for national veterans-

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • v.9 no.1
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    • pp.16-21
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    • 2021
  • As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

A Study on the Installation of a Sewage Separator Pipe inside an Existing Combined Sewer System for CSO Control (기존 합류식 하수관거에 CSO 제어를 위한 하수분리관의 설치에 관한 연구)

  • Guerra, Heidi B.;Kim, Youngchul
    • Journal of Wetlands Research
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    • v.23 no.1
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    • pp.85-93
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    • 2021
  • Sewage separation which often involves installing a new pipe to separate wastewater flow from stormwater runoff flow can be costly and depends highly on its feasibility in a site. To be able to develop a potentially more economical alternative that can also lessen major road traffic disturbance during this process, a different approach where a smaller sewage separator pipe is installed inside an existing combined sewer pipe was investigated. A small-scale of a box sewer and the proposed sewage separator pipe was constructed in the laboratory to observe and compare the deposition of solids and other solid-associated major pollutants at different flow rates. In addition, three-dimensional flow simulations considering five different scenarios were conducted using Ansys Fluent to observe the effect of the proposed sewage separator pipe to the hydraulic flow if installed inside the combined sewer pipe. Results revealed that the deposition of TSS, TCOD, TN, and TP were reduced by at least 60% when the wastewater was conveyed by the sewage separator pipe instead of the combined sewer pipe. Moreover, the flow simulations conducted showed that there was little to no major disturbance in hydraulic flow and velocity distribution when the sewage separator was installed inside a straight pipe and even at pipe transitions such as intersections, turns, and drop in elevation. Considering the pipe dimensions and the results of the study, the proposed approach can be promising in terms of reduction in pollutant deposition without a major effect on the hydraulic flow. Further investigation and cost-analysis should be done in the future to support these preliminary findings and help alleviate the problems caused by combined sewer overflows by introducing an alternative approach.

Seaweed ethnobotany of eastern Sorsogon, Philippines

  • Dumilag, Richard V.;Belgica, Teresa Haide R.;Mendoza, Lynn C.;Hibay, Janet M.;Arevalo, Abel E. Jr.;Malto, Mark Ariel D.;Orgela, Elden G.;Longavela, Mabille R.;Corral, Laurence Elmer H.;Olipany, Ruby D.;Ruiz, Caesar Franz C.;Mintu, Cynthia B.;Laza, Benilda O.;Pablo, Mae H. San;Bailon, Jinky D.;Berdin, Leny D.;Calaminos, Franklin P.;Gregory, Sheryll A.;Omoto, Annie T.;Chua, Vivien L.;Liao, Lawrence M.
    • ALGAE
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    • v.37 no.3
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    • pp.227-237
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    • 2022
  • Knowledge on the seaweeds of eastern Sorsogon in the Philippines is uneven. Not only is eastern Sorsogon among the areas of high seaweed diversity but locals there have interacted with seaweeds for ages. Despite seaweeds' assumed importance to Sorsoganon, ethnobotanical records are missing. In this study, we documented the traditional knowledge on seaweed use and determined the rate of knowledge transmission among the locals of eastern Sorsogon. Vernacular names and modes of preparation were given of the 12 identified species bearing culinary and medicinal importance. Ten species were eaten while three were used therapeutically. Based on ethnobotanical indices, Caulerpa chemnitzia ecad turbinata and Gelidiella acerosa were the most important seaweeds. The least cited was Caulerpa racemosa. Our study demonstrated that most of the seaweed resources in eastern Sorsogon remain largely untapped, as the identified ethnotaxa were only about 5% of the total seaweed species diversity reported for the area. The seaweed knowledge in eastern Sorsogon appeared to be homogenous across age groups with primary sources of knowledge biased towards female relatives (mothers and grandmothers) and to children as inheritors. Cessation of seaweed knowledge may come at a potential cost, as a significant fraction of the population did not transmit their knowledge to others. Our study furthered the interest in providing sophisticated resource management recommendations that consider the relationships of traditional and scientific knowledge of seaweed selection and use in eastern Sorsogon and beyond.

The Integrational Operation Method for the Modeling of the Pan Evaporation and the Alfalfa Reference Evapotranspiration (증발접시 증발량과 알팔파 기준증발산량의 모형화를 위한 통합운영방법)

  • Kim, Sungwon;Kim, Hung Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.2B
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    • pp.199-213
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    • 2008
  • The goal of this research is to develop and apply the integrational operation method (IOM) for the modeling of the monthly pan evaporation (PE) and the alfalfa reference evapotranspiration ($ET_r$). Since the observed data of the alfalfa $ET_r$ using lysimeter have not been measured for a long time in Republic of Korea, Penman-Monteith (PM) method is used to estimate the observed alfalfa $ET_r$. The IOM consists of the application of the stochastic and neural networks models, respectively. The stochastic model is applied to generate the training dataset for the monthly PE and the alfalfa $ET_r$, and the neural networks models are applied to calculate the observed test dataset reasonably. Among the considered six training patterns, 1,000/PARMA(1,1)/GRNNM-GA training pattern can evaluate the suggested climatic variables very well and also construct the reliable data for the monthly PE and the alfalfa $ET_r$. Uncertainty analysis is used to eliminate the climatic variables of input nodes from 1,000/PARMA(1,1)/GRNNM-GA training pattern. The sensitive and insensitive climatic variables are chosen from the uncertainty analysis of the input nodes. Finally, it can be to model the monthly PE and the alfalfa $ET_r$ simultaneously with the least cost and endeavor using the IOM.

A Study of Perceptions among Middle-aged and Older Koreans about Dying Well: Focusing on Typology (중노년층의 좋은 죽음에 대한 인식: 유형화를 중심으로)

  • Lee, Sunhee;Chung, Kyunghee
    • 한국노년학
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    • v.39 no.2
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    • pp.305-323
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    • 2019
  • In recognition of the increasing social attention paid to the notion of how to die well, this study explored what it is that middle-aged and older Koreans think of as "dying well." Specifically, it was aimed at classifying the perceptions people middle-aged and older have regarding dying well. To this end, we used data from the National Survey on Well-Dying, which was conducted in 2018 by the Korea Institute for Health and Social Affairs, and employed Latent Class Analysis. The demographic characteristics of each of the classified subgroups were identified through technical statistics. The types identified were multilayered depending on the imminence of death, perspectives of the last stages before dying, and the meaning of death in the context of social relationships. These types differed according to gender and subjective health conditions. Based on our findings in this study, we put forward policy suggestions about awareness improvement of personal and social levels, promoting on comprehensive death preparation, providing a system to reduce the cost of medical and nursing expense at the end of one's life, promoting of the right to self-determination regarding death, raising social attention to groups that are least prepared for dying well.