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The Problem and Resolution of The Act for Prevention of Insurance Fraud

  • Kim, Hyun-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.1
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    • pp.207-215
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    • 2019
  • The insurance system is indispensable to our society. However in recent years, there have been a lot of insurance fraud crimes, such as the abuse of these valuable insurance system and the cheating the insurance proceeds. These insurance frauds make the insurance companies harder to manage, and as a result, the insurance premiums have risen, which has caused a lot of damaging good policyholders. However, the damage caused by insurance fraud has been continuously increasing due to the punishment of cotton stick. Therefore, after the long discussion, the 'The Act for Prevention of Insurance Fraud', which is a special law recently has been enacted. However, within two years of the enactment of this law, which was enacted after much anticipation and long waiting, there is already debate about its effectiveness. The reason for this is that even though the law was enacted and enforced, insurance fraud continues to increase and even punishment for these crimes is not strengthened, and now it is time to look for specific problems and resolutions for these crimes see. So in this paper the author dealt with the problems of the law, first, related regulation of insurance payment, second, right to terminate insurance contract and return of insurance proceeds, third, regulation on notification of investigations, fourth, regulations on the adequacy of hospitalization. Of course, since this law has just been enacted, there are many other problems besides these problems, but I tried to present a fresh resolution based on the problems that have been mainly discussed since the legislative period.

Travel of the Park G$\ddot{u}$ell in Spain Barcelona which were designed and made a construction by Antoni Gaudi, as a genius artist, and review the works of residential development-Park G$\ddot{u}$ell, and also bridge made by stone bricks in the compound (기행문 - 스페인에서 본 천재 예술가(藝術家) 가우디(Antoni Gaudi)가 설계.시공한 구엘공원(Park G$\ddot{u}$ell) 주거단지와 경내(境內)에 건설한 석조교량(石造橋梁)에 대한 소고(小考))

  • Jo, Gyu-Yeong
    • Journal of the Korea Construction Safety Engineering Association
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    • s.55
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    • pp.37-51
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    • 2012
  • There is a shround of mystery surronnding Gaudi. In all probability, the first mist preventing us from gaining acess to his work is the intrinstic mysteriousness of all genius and, at the end of the day, of all human spirit. The situation is complicated by the well-known fact that Gaudi wished to creat an aura of silence around his persona, while, at the same time as maintaining this secretiveneness - in other words, the annihiliation of his fundamental values-gave expression and symbolisation to his moods and incerdible mental power. On a piece of land on the Muntanya Pelada, in the Barcelona district of La Salut, Eusebi G$\ddot{u}$ell Wanted to build an urbanisation inspired by the concepe of the garden city. in this he sought to return to nature, health and an escape from the insalubrous industrial city. Gaudi worked on the construction of this park between 1900 and 1914, and even moved his home there in 1906. An outstanding feature of park G$\ddot{u}$ell is the integration of architecture with nature. In other to save the natural slopes, Gaudi built viaducts from brick pillars, which he covered with stone obtained from the excavation.

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The evaluation of T-P removal and dewaterability under the operation change in KIDEA process (-기술정보- 연속유입 KIDEA에서 공정변화에 따른 인제거 및 탈수 함수율 상관관계)

  • Yeon, seung jun;Her, hee seung
    • Journal of Korean Society of Water and Wastewater
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    • v.22 no.2
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    • pp.179-182
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    • 2008
  • The KIDEA process, occurred in single reactor, is operated by three consequential steps, i.e., aerobic, settling, and discharge while introducing wastewater into the bottom of reactor continuously. It could accomplish biological oxidation (BOD), nitrification, denitrification (T-N), phosphate removal (T-P), and solid separation (SS) through the operational mode mentioned. Especially, this system has removed the T-P by wasting certain amount of sludge at the end of aeration phase during 5~10 minutes and not returned the activated sludge into the reactor, that is, no RAS (Return Activated Sludge). All running mode and instrumentation were controlled by the PLC equipment automatically. In this study, therefore, we have evaluated T-P removal efficiency and moisture content (MC) performance under the different excess sludge wasting mode. T-P track study and MC with TS concentration were analyzed during aerobic and settling phase. It has revealed that there was no significant difference of released T-P concentration between the first case which waste the sludge at the end of aerobic phase (0.2mg/L) and the second case which waste the sludge at 40 min of settling phase (0.25mg/L). Also, dewatering duration and MC have decreased 1.7% when TS concentration was increased from 0.31% to 0.5% during aerobic condition. Hence, it has concluded the system performance was less influenced by the operation time change of PLC program.

Nursing Care Fraud and False Billing - With the Case Study Basis - (요양급여의 허위.부정청구 -사례연구 중심으로-)

  • Huh, Su-Jin
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.41-69
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    • 2012
  • First introduced in 1977, Korean health care system reached to national coverage in short period of time never seen before in any other countries, and rated as successful system protecting the health of the public at relatively low price. However, despite those positive evaluations, some of fraudulent medical organizations or pharmacies are hindering the sound development of the national health care system with meticulous false billing exaggerating the number of patients or the days of their treatment. To prevent aforementioned nursing home fraud and false billing, the misconduct should be punished as subject to the criminal law and severally punished for fines and payments which far exceed the expected amount of illicit gains as it is basically violation of criminal fraud, other than the forced return of illicit gains based on civil laws. Furthermore, the Health Insurance Review and Assessment Service should strengthen and complement the fraud investigators, the review process, and the professional training to raise the detection rates. It might also want to review ways to implement whistleblower rewarding system and rewards for evidences of healthcare fraud to overcome the limits of external review.

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Medicinal Leech Therapy for Salvage of the Failing Flap (피판 부전증의 구제를 위한 약용거머리 치료법)

  • Baek Chung-Hwan;Shin Juno;Park Joo-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.20-25
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    • 2000
  • The medicinal leech, Hirudo medicinalis, has been used for salvage of the venous-congested flap following reconstructive surgery, with increasing frequency during the last two decades. Medicinal leech therapy is a safe, efficacious, economical, and well-tolerated intervention. The flap salvage with leeching occurs in approximately 70% of cases, and leeches need to be used as early as possible. At the time of the bite, evacuation of blood and injection of the leech saliva products, including anticoagulants and inhibitors of platelet aggregation, maintain capillary circulation of the flap, and then venous capillary return is established across the wound by angiogenesis. One of the salivary products, hirudin, represents the first parenteral anticoagulant introduced since the discovery of heparin. We analyzed two cases in which flap salvage with leeching was attempted, and reviewed medicinal leech therapy on the basis of our experiences and literature review. This has not been documented in the head and neck surgery literature in our country.

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Spectrum Allocation based on Auction in Overlay Cognitive Radio Network

  • Jiang, Wenhao;Feng, Wenjiang;Yu, Yang
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.9 no.9
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    • pp.3312-3334
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    • 2015
  • In this paper, a mechanism for spectrum allocation in overlay cognitive radio networks is proposed. In overlay cognitive radio networks, the secondary users (SUs) must first sense the activity of primary users (PUs) to identify unoccupied spectrum bands. Based on their different contributions for the spectrum sensing, the SUs get payoffs that are computed by the fusion center (FC). The unoccupied bands will be auctioned and SUs are asked to bid using payoffs they earned or saved. Coalitions are allowed to form among SUs because each SU may only need a portion of the bands. We formulate the coalition forming process as a coalition forming game and analyze it by game theory. In the coalition formation game, debtor-creditor relationship may occur among the SUs because of their limited payoff storage. A debtor asks a creditor for payoff help, and in return provides the creditor with a portion of transmission time to relay data for the creditor. The negotiations between debtors and creditors can be modeled as a Bayesian game because they lack complete information of each other, and the equilibria of the game is investigated. Theoretical analysis and numerical results show that the proposed auction yields data rate improvement and certain fairness among all SUs.

Does Investor Sentiment Influence Stock Price Crash Risk? Evidence from Saudi Arabia

  • ALNAFEA, Maryam;CHEBBI, Kaouther
    • The Journal of Asian Finance, Economics and Business
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    • v.9 no.1
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    • pp.143-152
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    • 2022
  • This paper examines the relationship between investor sentiment and the risk of a stock price crash at the firm level. Our dataset includes 131 firms listed on the Saudi stock exchange (Tadawul) from 2011 to 2019, as well as 953 firm-year observations. To evaluate crash risk, we employ two distinct proxies and propose an index for measuring firm-level sentiment which we use for the first time in our study. The average turnover rate, price-earnings ratio, and overnight return are the three sentiment proxies we utilize in our index. Our findings show that high levels of investor emotion increase managers' proclivity to withhold unfavorable news from investors, which aggravates the risk of a stock price crash. We undertake cross-sectional regressions by sector to ensure the robustness of our findings, and our findings are confirmed. After accounting for any endogeneity issues with the GMM technique, the results remain the same. Furthermore, we analyze the liquidity effect by dividing our sample into subsamples with better and worse liquidity and find that firms with worse liquidity have a considerably greater positive impact of investor mood. Overall, our findings help investors and regulators recognize the significance of this downside risk and how to manage it in the stock market.

Automatic identification of Java Method Naming Patterns Using Cascade K-Medoids

  • Kim, Tae-young;Kim, Suntae;Kim, Jeong-Ah;Choi, Jae-Young;Lee, Jee-Huong;Cho, Youngwha;Nam, Young-Kwang
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.12 no.2
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    • pp.873-891
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    • 2018
  • This paper suggests an automatic approach to extracting Java method implementation patterns associated with method identifiers using Cascade K-Medoids. Java method implementation patterns indicate recurring implementations for achieving the purpose described in the method identifier with the given parameters and return type. If the implementation is different from the purpose, readers of the code tend to take more time to comprehend the method, which eventually affects to the increment of software maintenance cost. In order to automatically identify implementation patterns and its representative sample code, we first propose three groups of feature vectors for characterizing the Java method signature, method body and their relation. Then, we apply Cascade K-Medoids by enhancing the K-Medoids algorithm with the Calinski and Harrabasez algorithm. As the evaluation of our approach, we identified 16,768 implementation patterns of 7,169 method identifiers from 50 open source projects. The implementation patterns have been validated by the 30 industrial practitioners with from 1 to 6 years industrial experience, resulting in 86% of the precision.

Normalization Effect of Both ST36 and CV11, 12, 13 Meridian Points on the Abnormal Gastric Myoelectrical Activity in Two Cases of Functional Dyspeptic Patients (족삼리와 상완, 중완, 하완혈의 침 자극으로 기능성 소화불량증 환자의 위 평활근 전기적 활성 장애를 정상화시켰던 증례 2례)

  • Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.707-717
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    • 2021
  • Objectives: The aim of this study was to introduce the normalization effects of stimulation of both ST36 and CV11, 12, 13 meridian points on the abnormal gastric myoelectrical activity in two cases of functional dyspeptic patients with gastric dysmotility. Methods: Gastric myoelectrical activity was recorded by electrogastrography every two weeks until their gastric myoelectrical activity finally reached the normality. Dominant frequency of gastric slow waves in the fasting and postprandial periods and a dominant power ratio were obtained on each occasion. Patients were treated three times each day: 9 am, 1 pm, and 7 pm. The first treatment consisted of manual and immersion stimulation on all used meridian points for 20 min. In the second and third treatments, electrical stimulation of both ST36 was added. It was conducted for 20 min at a strength intensity of 1.2 times the pain threshold at a frequency of 3 Hz. Results: Stimulation of the above meridian points normalized abnormal gastric myoelectrical activity. The time taken to return from abnormal gastric myoelectrical activity to normal was 16-19 weeks. Conclusion: Stimulation of both ST36 and CV11, 12, 13 meridian points normalized the abnormal gastric myoelectrical activity in the functional dyspepsia of gastric dysmotility.

EFTG: Efficient and Flexible Top-K Geo-textual Publish/Subscribe

  • zhu, Hong;Li, Hongbo;Cui, Zongmin;Cao, Zhongsheng;Xie, Meiyi
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.12 no.12
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    • pp.5877-5897
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    • 2018
  • With the popularity of mobile networks and smartphones, geo-textual publish/subscribe messaging has attracted wide attention. Different from the traditional publish/subscribe format, geo-textual data is published and subscribed in the form of dynamic data flow in the mobile network. The difference creates more requirements for efficiency and flexibility. However, most of the existing Top-k geo-textual publish/subscribe schemes have the following deficiencies: (1) All publications have to be scored for each subscription, which is not efficient enough. (2) A user should take time to set a threshold for each subscription, which is not flexible enough. Therefore, we propose an efficient and flexible Top-k geo-textual publish/subscribe scheme. First, our scheme groups publish and subscribe based on text classification. Thus, only a few parts of related publications should be scored for each subscription, which significantly enhances efficiency. Second, our scheme proposes an adaptive publish/subscribe matching algorithm. The algorithm does not require the user to set a threshold. It can adaptively return Top-k results to the user for each subscription, which significantly enhances flexibility. Finally, theoretical analysis and experimental evaluation verify the efficiency and effectiveness of our scheme.