• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.101-112
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• 2019

Purpose: The purpose of the study was to contribute to the prevention of musculoskeletal disorders (MSDs) in 119 emergency medical technicians (EMTs) by evaluating ergonomic risk factors of patient lifting work-postures. Methods: Four procedures were evaluated: using long back-board (LBB) on the sitting and standing main stretcher, using variable stretcher on the sitting and standing main stretcher. Wok-postures were assessed during training. Results: In using LBB on the sitting main stretcher, the OWAS-score was Mode:3 (Mean:2.30, Maximum:3), the REBA-score was Mode:9 (Mean:7.61, Maximum:11), requiring improvement soon. In using LBB on the standing main stretcher, the OWAS-score was Mode:3 (Mean:2.33, Maximum:3), requiring as soon as possible corrective action, the REBA-score was Mode:6 (Mean:5.44, Maximum:11), requiring improvement. In using variable stretcher on the sitting main stretcher, the OWAS-score was Mode:1 (Mean:1.85, Maximum:3), not requiring corrective action, the REBA-score was Mode:6 (Mean:6.78, Maximum:11), requiring improvement. In using variable stretcher on the standing main stretcher, the OWAS-score was Mode:3 (Mean:2.84, Maximum:3), requiring as soon as possible corrective action, the REBA-score was Mode:11 (Mean:9.38, Maximum:11), requiring immediate improvement. Conclusion: All four-procedures showed improvement in work-posture. Thereby, required attention and management in training, occupational health professionals should participate in change of lifting-method, and programs aimed at preventing MSDs should be developed and implemented in fire-academy and fire-station.

• International Journal of Computer Science & Network Security
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• v.21 no.9
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• pp.19-30
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• 2021

Diabetes Mellitus (DM) is one of common chronic diseases leading to severe health complications that may cause death. The disease influences individuals, community, and the government due to the continuous monitoring, lifelong commitment, and the cost of treatment. The World Health Organization (WHO) considers Saudi Arabia as one of the top 10 countries in diabetes prevalence across the world. Since most of the medical services are provided by the government, the cost of the treatment in terms of hospitals and clinical visits and lab tests represents a real burden due to the large scale of the disease. The ability to predict the diabetic status of a patient without the laboratory tests by performing screening based on some personal features can lessen the health and economic burden caused by diabetes alone. The goal of this paper is to investigate the prediction of diabetic and prediabetic patients by considering factors other than the laboratory tests, as required by physicians in general. With the data obtained from local hospitals, medical records were processed to obtain a dataset that classified patients into three classes: diabetic, prediabetic, and non-diabetic. After applying three machine learning algorithms, we established good performance for accuracy, precision, and recall of the models on the dataset. Further analysis was performed on the data to identify important non-laboratory variables related to the patients for diabetes classification. The importance of five variables (gender, physical activity level, hypertension, BMI, and age) from the person's basic health data were investigated to find their contribution to the state of a patient being diabetic, prediabetic or normal. Our analysis presented great agreement with the risk factors of diabetes and prediabetes stated by the American Diabetes Association (ADA) and other health institutions worldwide. We conclude that by performing class-specific analysis of the disease, important factors specific to Saudi population can be identified, whose management can result in controlling the disease. We also provide some recommendations learnt from this research.

• Journal of radiological science and technology
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• v.45 no.2
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• pp.127-134
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• 2022

In order to overcome the image quality limitations of the conventional C-arm, a flat panel detector (FPD) is used to enhance spatial resolution, detective quantum efficiency, frame rate, and dynamic range. Three-dimensional (3D) visualized information can be obtained from C-arm computed tomography (CT) equipped with an FPD, which can reduce patient discomfort and provide various medical information to health care providers by conducting procedures in the interventional procedure room without moving the patient to the CT scan room. Unlike a conventional C-arm device, a C-arm CT requires different basic safety and essential performance evaluation criteria; therefore, in this study, basic safety and essential performance evaluation criteria to protect patients, medical staff, and radiologists were derived based on International Electrotechnical Commission (IEC) standards, the Ministry of Food and Drug Safety (MFDS) standards in Korea, and the rules on the installation and operation of special medical equipment in Korea. As a result of the study, six basic safety evaluation criteria related to electrical and mechanical radiation safety (leakage current, collision protection, emergency stopping device, overheating, recovery management, and ingress of water or particulate matter into medical electrical (ME) equipment and ME systems: footswitches) and 14 essential performance evaluation criteria (accuracy of tube voltage, accuracy of tube current, accuracy of loading time, accuracy of current time product, reproducibility of radiation output, linearity and consistency in radiography, half layer value in X-ray equipment, focal size and collimator, relationship between X-ray field and image reception area, consistency of light irradiation versus X-ray irradiation, performance of the mechanical device, focal spot to skin distance accuracy, image quality evaluation, and technical characteristic of cone-beam computed tomography) were selected for a total of 20 criteria.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.193-199
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• 2017

Background: Although there more than 1,000 liver transplantations (LTs) are performed in Korea annually, their immense cost remains a great hurdle. Hence, in an attempt to reduce the medical costs of LT, a program was initiated at a public hospital affiliated with the Seoul National University Hospital. Methods: A total of 11 LTs have been successfully executed since the first LT performed at Seoul Metropolitan Government Seoul National University Boramae Medical Center in July 2011 through December 2014. Results: Nine patients (81.8%) were male and two (18.2%) were female. The mean age of patients was 53.4±11.4 years. Hepatitis B virus-related liver disease (n=6, 54.5%) was the most common causative disease, followed by alcoholic liver disease (ALD) (n=4, 36.4%). The actuarial 3-year survival rate was 90.9%. The median total medical cost of LTs was US $41,583 (calculated from operation to discharge), but only $11,860 was actually charged for patients with health insurance coverage. One female patient who had undergone deceased donor LT for alcoholic liver cirrhosis died during follow-up. This patient was non-compliant with the medical instructions after discharge, and finally expired due to septic shock at 10 months post-LT. Conclusions: In the public hospital, LT was successfully performed at a much lower cost. However, LT guidelines and peritransplant management protocols for patients with ALD must be established before escalating LT at public hospitals since ALD with poor compliance is one of the most common causes of complications at public hospitals.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.36-43
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• 2024

Background: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory failure, which frequently necessitates invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO). However, the limited availability of ECMO resources poses challenges to patient selection and associated decision-making. Consequently, this retrospective single-center study was undertaken to evaluate the characteristics and clinical outcomes of patients with COVID-19 receiving ECMO. Methods: Between March 2020 and July 2022, 65 patients with COVID-19 were treated with ECMO and were subsequently reviewed. Patient demographics, laboratory data, and clinical outcomes were examined, and statistical analyses were performed to identify risk factors associated with mortality. Results: Of the patients studied, 15 (23.1%) survived and were discharged from the hospital, while 50 (76.9%) died during their hospitalization. The survival group had a significantly lower median age, at 52 years (interquartile range [IQR], 47.5-61.5 years), compared to 64 years (IQR, 60.0-68.0 years) among mortality group (p=0.016). However, no significant differences were observed in other underlying conditions or in factors related to intervention timing. Multivariable analysis revealed that the requirement of a change in ECMO mode (odds ratio [OR], 366.77; 95% confidence interval [CI], 1.92-69911.92; p=0.0275) and the initiation of continuous renal replacement therapy (CRRT) (OR, 139.15; 95% CI, 1.95-9,910.14; p=0.0233) were independent predictors of mortality. Conclusion: Changes in ECMO mode and the initiation of CRRT during management were associated with mortality in patients with COVID-19 who were supported by ECMO. Patients exhibiting these factors require careful monitoring due to the potential for adverse outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.2
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• pp.125-132
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• 2020

Objectives: The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting. Materials and Methods: The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed. Results: A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P<0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; P<0.001). Conclusion: Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• Journal of Korean Biological Nursing Science
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• v.6 no.2
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• pp.43-55
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• 2004

Purpose : This study was conducted to identify the peritonitis occurence of CAPD, by which a basis for efficient patient management could be provided. Method: Data were collected by questionnaires and hospital record from 55 people who underwent or were going through CAPD from January 1998 to April 2004 in a university subsidiary hospital kidney department. Result: 1) There were many elderly people of 61 years or above taking up 50.9%, 75% had low levels of education with middle school graduation or less, and the cases where separate individual rooms enabling the exchange of CAPD were not possessed was shown to be 61.8%. 2) With the management feature of CAPD, those who bathed once or less per 7 days made up 60.0%, and 60% washed their hands well before exchanging solutions which meant that 40% did not wash well or just washed moderately, and in terms of CAPD education, the proportion of those receiving education both before and after dialysis was 29.1%. also, with nutrition conditions, cases where the level of serum albumin was lower than 3.0 made up 38.2%, and those who were conducting self CAPD management was 65.5%, and cases where the management was done by the spouse or family members was revealed to be 34.5%. 3) There were Peritonitis occurrences in 40% of cases, and the number of Peritonitis occurrences within the period was 36, with an occurrence rate of $0.65{\pm}0.99$. Also, 66.7% of the causing bacteria were no growth, Gram positive bacteria made up 27.8%, and Gram negative bacteria consisted of 5.5%. 4) No significant difference was found peritionitis occurrence according to general and management characteristics. Lower peritionitis occurrence were shown with those who had spouses or family members conducting CAPD management as opposed to self-managing patients(p=0.037). Conclusion: Elderly patients there needs to be the participation of family or other support resources rather than subjecting them to self-management of solution exchange and entry/exit. Also, The high occurrence rate from Gram positive bacteria is shown so the importance of CAPD management education including bathing and hand washing needs to be emphasized.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.432-439
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• 2018

The purpose of this study was to analyze the knowledge, attitudes, safety management behavior, and radiation anxiety of dental hygienists and to analyze affecting factors in order to improve the level of radiation safety management and reduce anxiety. The study period consisted of 280 dental hygienists working in Jeollabuk-do from September 10 to October 31, 2017 using the SPSS 12.0 program, frequency, descriptive statistics, and multiple regression analysis. The average knowledge level of radiation quality control was 8.07, and the correct answer rate was 75.3%. The attitude level was 96.1%, and the radiation safety management behavior was 4.11 for the photographer and 4.58 for the 'always wear a TLD (personal dosimeter) during radiography'. Patient radiation safety management behavior was 3.86, and the highest was '4.69' to confirm pregnancy of the woman before radiography. Radiation-covered lining was 3.86, and was the highest at 4.13 for 'I am concerned about fetal health when I am pregnant'. Factors affecting radiation exposure anxiety were lower radiation safety management behaviors, lower age, lower radiographic experience, higher educational background, higher monthly income, and higher job title (p<0.05). Based on the above results, dental hygienists had strong knowledge, attitudes, and safety management practices for radiation quality control. However, since anxiety related to radiation exposure was high, it is possible to improve radiation safety management level and reduce radiation exposure anxiety.

• Journal of Digital Convergence
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• v.14 no.7
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• pp.309-319
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• 2016

There is a need to develop a data quality management algorithm in order to improve the quality of health care data. In this study, we developed a data quality control algorithms associated diseases related to diabetes in patients with hypertension. To make a data quality algorithm, we extracted hypertension patients from 2011 and 2012 discharge damage survey data. As the result of developing Data quality management algorithm, significant factors in hypertension patients with diabetes are gender, age, Glomerular disorders in diabetes mellitus, Diabetic retinopathy, Diabetic polyneuropathy, Closed [percutaneous] [needle] biopsy of kidney. Depending on the decision tree results, we defined Outlier which was probability values associated with a patient having diabetes corporal with hypertension or more than 80%, or not more than 20%, and found six groups with extreme values for diabetes accompanying hypertension patients. Thus there is a need to check the actual data contained in the Outlier(extreme value) groups to improve the quality of the data.