• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.53-61
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• 2016

PURPOSE. This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at $10^{th}$ year after the treatment, and more cost-effective regardless of the WTP from $20^{th}$ year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the $10^{th}$ year after the prosthodontic treatment, more than 35,000 won at the $20^{th}$ year after prosthodontic treatment. CONCLUSION. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the $10^{th}$ year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Earthquakes and Structures
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• v.11 no.3
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• pp.517-538
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• 2016

This paper presents a probabilistic fragility analysis for two groups of bridges: simply supported and integral bridges. Comparisons are based on the seismic fragility of the bridges subjected to accelerograms of two seismic sources. Three-dimensional finite-element models of the bridges were created for each set of bridge samples, considering the nonlinear behaviour of critical bridge components. When the seismic hazard in the site is controlled by a few seismic sources, it is important to quantify separately the contribution of each fault to the structure vulnerability. In this study, seismic records come from earthquakes that originated in strike-slip and reverse faulting mechanisms. The influence of the earthquake mechanism on the seismic vulnerability of the bridges was analysed by considering the displacement ductility of the piers. An in-depth parametric study was conducted to evaluate the sensitivity of the bridges' seismic responses to variations of structural parameters. The analysis showed that uncertainties related to the presence of lap splices in columns and superstructure type in terms of integral or simply supported spans should be considered in the fragility analysis of the bridge system. Finally, the fragility curves determine the conditional probabilities that a specific structural demand will reach or exceed the structural capacity by considering peak ground acceleration (PGA) and acceleration spectrum intensity (ASI). The results also show that the simply supported bridges perform consistently better from a seismic perspective than integral bridges and focal mechanism of the earthquakes plays an important role in the seismic fragility analysis of highway bridges.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.38 no.4
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• pp.117-131
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• 2015

Conventional data envelopment analysis (DEA) models require that inputs and outputs are given as crisp values. Very often, however, some of inputs and outputs are given as imprecise data where they are only known to lie within bounded intervals. While a typical approach to addressing this situation for optimization models such as DEA is to conduct sensitivity analysis, it provides only a limited ex-post measure against the data imprecision. Robust optimization provides a more effective ex-ante measure where the data imprecision is directly incorporated into the model. This study aims to apply robust optimization approach to DEA models with imprecise data. Based upon a recently developed robust optimization framework which allows a flexible adjustment of the level of conservatism, we propose two robust optimization DEA model formulations with imprecise data; multiplier and envelopment models. We demonstrate that the two models consider different risks regarding imprecise efficiency scores, and that the existing DEA models with imprecise data are special cases of the proposed models. We show that the robust optimization for the multiplier DEA model considers the risk that estimated efficiency scores exceed true values, while the one for the envelopment DEA model deals with the risk that estimated efficiency scores fall short of true values. We also show that efficiency scores stratified in terms of probabilistic bounds of constraint violations can be obtained from the proposed models. We finally illustrate the proposed approach using a sample data set and show how the results can be used for ranking DMUs.

• Korean Journal of Construction Engineering and Management
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• v.6 no.4 s.26
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• pp.80-90
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• 2005

Activity durations retain probabilistic and stochastic natures due to diverse factors causing the delay or acceleration of activity completion. These natures make the final project duration to be a random variable. These factors are the major source of financial risk. Extending the Stochastic Project Scheduling Simulation system (SPSS) developed in previous research; this research presents a method to estimate how the final project duration behaves when activity durations change randomly. The final project cost is estimated by considering the fluctuation of indirect cost, which occurs due to the delay or acceleration of activity completion, along with direct cost assigned to an activity. The final project cost is estimated by considering how indirect cost behaves when activity duration change. The method quantifies the amount of contingency to cover the expected delay of project delivery. It is based on the quantitative analysis to obtain the descriptive statistics from the simulation outputs (final project durations). Existing deterministic scheduling method apply an arbitrary figures to the amount of delay contingency with uncertainty. However, the stochastic method developed in this research allows computing the amount of delay contingency with certainty and certain degree of confidence. An example project is used to illustrate the quantitative analysis method using simulation. When the statistical location and shape of probability distribution functions defining activity durations change, how the final project duration and cost behave are ascertained using automated sensitivity analysis method

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.59-69
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• 2016

Background: The subcutaneous formulation of biologic disease-modifying antirheumatic drugs (DMARDs) was preferred due to favored self-administration and would be an economical treatment option for patients with rheumatoid arthritis. This study was to compare the economic impact of biologic DMARDs administered by subcutaneous injection in patients with rheumatoid arthritis who had inadequate response to conventional DMARDs. Methods: The cost-minimization analysis was conducted to estimate the lifetime health care costs of treatment sequences with subcutaneous biologic DMARDs as first-line therapy from a health care system perspective. The Markov model was developed to represent the transitions through treatment sequences based on American College of Rheumatology response rate and discontinuation rate. The health care costs comprised the cost of medications, administration, dispensing, outpatient visits, test/diagnostic examination, palliative therapy and treatment of serious infection. All costs were expressed in 2016 Korean Won (KRW) and discounted at 5%. Results: The mean lifetime health care cost per patient was lowest in the etanercept sequence, which was estimated at KRW 63,441,679. The incremental costs of the treatment sequence started with adalimumab, golimumab, abatacept, and tocilizumab were KRW 7,985,730, KRW 4,064,669, KRW 2,869,947, and KRW 4,282,833, respectively, relative to etanercept sequence. These differences in costs mainly were attributable to medication costs. One-way and probabilistic sensitivity analyses confirmed that etanercept represented the option with the lowest cost compared with comparators. Conclusion: This study found that etanercept is likely a cost-saving treatment option among subcutaneous biologic DMARDs in patients with rheumatoid arthritis.

• Journal of the Society of Naval Architects of Korea
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• v.32 no.1
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• pp.25-36
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• 1995

The application of the reliability analysis is investigated as a probabilistic approach to the assessment of ship's structural strength and to the establishment of design format for longitudinal strength. Reliability analyses are carried out for 34 ships of tankers and bulk carriers built in HHI for some failure modes such as tensile yielding, compressive buckling and ultimate strength of hull girder. The safety assessment of each ship, the calculation of sensitivity factors and the derivation of target reliability index are performed. As results. the difference of reliability indices among ships is great for all modes. To provide more uniform levels of safety the establishment of new strength criteria using partial safety factors is performed. The partial safety factors for the design format are obtained according to the AFOSM method and the reliability-conditioned(RC) method. Finally, a design format using partial safety factors has been proposed. We could find out that new strength criteria can produce consistent reliability indices which are close to the target value.

• Structural Engineering and Mechanics
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• v.22 no.6
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• pp.665-683
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• 2006

The strength behaviors of Fiber Reinforced Plastics (FRP) Composites can be greatly influenced by the properties of constitutive materials, the laminate structures, and load conditions etc, accompanied by many uncertainty factors. So the reliability study on FRP is an important subject of research. Many achievements have been made in reliability studies based on the probability theory, but little has been done on the roles played by fuzzy variables. In this paper, a fuzzy reliability model for FRP laminates is established first, in which the loads are considered as random variables and the strengths as fuzzy variables. Then a numerical model is developed to assess the fuzzy reliability. The Monte Carlo simulation method is utilized to compute the reliability of laminas under the maximum stress criterion. In the second part of this paper, a generalized fuzzy reliability model (GFRM) is proposed. By virtue of the fact that there may exist a series of states between the failure state and the function state, a fuzzy assumption for the structure state together with the probabilistic assumption for strength parameters is adopted to construct the GFRM of composite materials. By defining a generalized limit state function, the problem is converted to the conventional reliability formula that enables the first-order reliability method (FORM) applicable in calculating the reliability index. Several examples are worked out to show the validity of the models and the efficiency of the methods proposed in this paper. The parameter sensitivity analysis shows that some of the mean values of the strength parameters have great influence on the laminated composites' reliability. The differences resulting from the application of different failure criteria and different fuzzy assumptions are also discussed. It is concluded that the GFRM is feasible to use, and can provide an effective and synthetic method to evaluate the reliability of a system with different types of uncertainty factors.

• Journal of Korean Society on Water Environment
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• v.37 no.5
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• pp.369-380
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• 2021

In this work, we analyzed the effects of drought on the water temperature (WT) of Nakdong river basin major river sections using Standardized Precipitation Index (SPI) and WT data. The analysis was carried out on a seasonal basis. After calculating the optimal time scale of the SPI through the correlation between the SPI and WT data, we used the copula theory to model the joint probability distribution between the WT and SPI on the optimal time scale. During spring and fall, the possibility of environmental drought caused by high WT increased in most of the river sections. Notably, in summer, the possibility of environmental drought caused by high WT increased in all river sections. On the other hand, in winter, the possibility of environmental drought caused by low WT increased in most river sections. From the risk map, which quantified the sensitivity of WT to the risk of environmental drought, the river sections Nakbon C, Namgang E, and Nakbon K showed increased stress in the water ecosystem due to high WT when drought occurred in summer. When drought occurred in winter, an increased water ecosystem stress caused by falling WT was observed in the river sections Gilan A, Yongjeon A, Nakbon F, Hwanggang B, Nakbon I, Nakbon J, Nakbon K, Nakbon L, and Nakbon M. The methodology developed in this study will be used in the future to quantify the effects of drought on water quality as well as WT.

• Journal of Korean Society of Transportation
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• v.18 no.6
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• pp.89-99
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• 2000

To cope with the limits of conventional O-D trip matrix collecting methods, several approaches have been developed. One of them is bilevel Programming method Proposed by Yang(1995), which uses Sensitivity Analysis Based(SAB) algorithm to solve Generalized Least Square(GLS) problem. However, the SAB a1gorithm has revealed two critical short-comings. The first is that when there exists a significant difference between target O-D matrix and true O-D matrix, SAB algorithm may not produce correct solution. This stems from the heavy dependance on the historical O-D information, in special when gravel Patterns are dramatically changed. The second is the assumption of iterative linear approximation to original Problem. Because of the approximation, SAB algorithm has difficulty in converging to Perfect Stackelberg game condition. So as to avoid the Problems. we need a more robust and stable solution method. The main purpose of this Paper is to show the problem of the dependency of Previous models and to Propose an alternative solution method to handle it. The Problem of O-D matrix estimation is intrinsically nonlinear and nonconvex. thus it has multiple solutions. Therefore it is necessary to require a method for searching globa1 solution. In this paper, we develop a solution algorithm combined with genetic algorithm(GA) , which is widely used as probabilistic global searching method To compare the efficiency of the algorithm, SAB algorithm suggested by Yang et al. (1992,1995) is used. From the results of numerical example, the Proposed algorithm is superior to SAB algorithm irrespective of travel patterns.