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A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework

  • Mohammadshahi, Marita;Yazdani, Shahrooz;Olyaeemanesh, Alireza;Sari, Ali Akbari;Yaseri, Mehdi;Sefiddashti, Sara Emamgholipour
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.2
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    • pp.72-81
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    • 2019
  • Objectives: The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods: This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results: The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage. Conclusions: A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.

Process Induced Warpage Simulation for Panel Level Package (기판 소재에 따른 패널 레벨 패키지 공정 단계별 warpage 해석)

  • Moon, Ayoung;Kim, Sungdong
    • Journal of the Microelectronics and Packaging Society
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    • v.25 no.4
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    • pp.41-45
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    • 2018
  • We have simulated the process induced warpage for panel level package using finite element method. Silicon chips of $5{\times}5mm^2$ were redistributed on $122.4{\times}93.6mm^2$ size panel and the total number of redistributed chips was 221. The warpage at each process step, for example, (1) EMC molding, (2) attachment of detach core, (3) heating, (4) removal of a carrier, and (5) cooling was simulated using ANSYS and the effects of detach core and carrier materials on the warpage were investigated. The warpage behaved complexly depending on the materials for the detach core and carrier. However, glass carrier showed the lower warpage than FR4 carrier regardless of detach core material, and the minimum warpage was observed when the glass was used for the detach core and carrier at the same time.

A Performance Evaluation of QE-MMA Adaptive Equalization Algorithm based on Quantizer-bit Number and Stepsize (QE-MMA 적응 등화 알고리즘에서 양자화기 비트수와 Stepsize에 의한 성능 평가)

  • Lim, Seung-Gag
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.21 no.1
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    • pp.55-60
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    • 2021
  • This paper relates with the performance evaluation of QE-MMA (Quantized Error-MMA) adaptive equalization algorithm based on the stepsize and quantizer bit number in order to reduce the intersymbol interference due to nonlinear distortion occurred in the time dispersive channel. The QE-MMA was proposed using the power-of-two arithmetic for the H/W implementation easiness substitutes the multiplication and addition into the shift and addition in the tap coefficient updates process that modifies the SE-MMA which use the high-order statistics of transmitted signal and sign of error signal. But it has different adaptive equalization performance by the step size and quantizer bit number for obtain the sign of error in the generation of error signal in QE-MMA, and it was confirmed by computer simulation. As a simulation, it was confirmed that the convergence speed for reaching steady state depend on stepsize and the residual quantities after steady state depend on the quantizer bit number in the QE-MMA adaptive equalization algorithm performance.

A study on the perception of dental hygienists according to the clinical application experience of digital intraoral scanners: focusing on the comparison with conventional impression (구강 스캐너 임상적용 경험에 따른 치과위생사의 인식 연구: 전통적 인상채득과의 비교를 중심으로)

  • Myoung-Hee, Kim;Young Sun, Hwang;Hang-Sik, Park
    • Journal of Korean Academy of Dental Administration
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    • v.10 no.1
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    • pp.84-92
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    • 2022
  • Impression taking is one of the most frequently performed tasks within the legal scope of dental hygienists. This study aims to compare traditional impression and digital impression taking in various aspects with dental hygienists who have experience using digital intraoral scanners. A total of 61 subjects were included in this analysis. Traditional and digital impression taking were compared, and the perception of intraoral scanners was classified into four factors through exploratory factor analysis. After a normality test of the main variables was performed, a non-parametric test was performed. In terms of the adequacy of the size of the tool inserted into the oral cavity, traditional impression taking was more positive, and there was no significant difference in the precision of impression taking, fit of the prosthesis, and time efficiency. In contrast, the digital intraoral scanner was positive in terms of reducing nausea. In the comparison between the items of the digital intraoral scanner, relatively low satisfaction was shown in terms of convenience of use. This study compared traditional impression taking based on the experience of dental hygienists using oral scanners. It is hoped that this will be one step closer to universalization. In addition, appropriate training on how to use them should be provided.

Grain Shape and Grain Growth Behavior in the (K0.5Na0.5)NbO3-CaZrO3 System ((K0.5Na0.5)NbO3-CaZrO3 계에서 입자모양과 입자성장 거동)

  • Lee, Chul-Lee;Moon, Kyoung-Seok
    • Journal of Powder Materials
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    • v.29 no.2
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    • pp.110-117
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    • 2022
  • The grain growth behavior in the (1-x)K0.5Na0.5NbO3-xCaZrO3 (KNNCZ-x) system is studied as a function of the amount of CZ and grain shape. The (1-x)K0.5Na0.5NbO3-xCaZrO3 (KNNCZ-x) powders are synthesized using a conventional solid-state reaction method. A single orthorhombic phase is observed at x = 0 - 0.03. However, rhombohedral and orthorhombic phases are observed at x = 0.05. The grain growth behavior changes from abnormal grain growth to the suppression of grain growth as the amount of CaZrO3 (CZ) increases. With increasing CZ content, grains become more faceted, and the step-free energy increases. Therefore, the critical growth driving force increases. The grain size distribution broadens with increasing sintering time in KNNCZ-0.05. As a result, some large grains with a driving force larger than the critical driving force for growth exhibit abnormal grain growth behavior during sintering. Therefore, CZ changes the grain growth behavior and microstructure of KNN. Grain growth at the faceted interface of the KNNCZ system occurs via two-dimensional nucleation and growth.

State recognition of fine blanking stamping dies through vibration signal machine learning (진동신호 기계학습을 통한 프레스 금형 상태 인지)

  • Seok-Kwan Hong;Eui-Chul Jeong;Sung-Hee Lee;Ok-Rae Kim;Jong-Deok Kim
    • Design & Manufacturing
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    • v.16 no.4
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    • pp.1-6
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    • 2022
  • Fine blanking is a press processing technology that can process most of the product thickness into a smooth surface with a single stroke. In this fine blanking process, shear is an essential step. The punches and dies used in the shear are subjected to impacts of tens to hundreds of gravitational accelerations, depending on the type and thickness of the material. Therefore, among the components of the fine blanking mold (dies), punches and dies are the parts with the shortest lifespan. In the actual production site, various types of tool damage occur such as wear of the tool as well as sudden punch breakage. In this study, machine learning algorithms were used to predict these problems in advance. The dataset used in this paper consisted of the signal of the vibration sensor installed in the tool and the measured burr size (tool wear). Various features were extracted so that artificial intelligence can learn effectively from signals. It was trained with 5 features with excellent distinguishing performance, and the SVM algorithm performance was the best among 33 learning models. As a result of the research, the vibration signal at the time of imminent tool replacement was matched with an accuracy of more than 85%. It is expected that the results of this research will solve problems such as tool damage due to accidental punch breakage at the production site, and increase in maintenance costs due to prediction errors in punch exchange cycles due to wear.

An Algorithm For Approximating The Performance of Multi-mode Network System Using Algebraic Property of System States (시스템 상태의 대수적 성질을 이용한 다중모드 네트워크 시스템 성능 근사계산 알고리즘)

  • Oh, Dae-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.14 no.12
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    • pp.127-137
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    • 2009
  • A practical algorithm of generating most probable states in decreasing order of probability of the network system state is suggested for approximating the performance of multi-mode network system using algebraic structure of the system states. Most complex system having network structure with multi-mode unit state is difficult to evaluate the performance or reliability due to exponentially increasing size of state space. Hence not an exact computing method but an approximated one is reasonable approach to solve the problem. To achieve the goal we should enumerate the network system states in order as a pre-processing step. In this paper, we suggest an improved algorithm of generating most probable multi-mode states to get the ordered system states efficiently. The method is compared with the previous algorithms in respective to memory requirement and empirical computing time. From the experiment proposed method has some advantages with regard to the criterion of algorithm performance. We investigate the advantages and disadvantage by illustrating experiment examples.

Potential of River Bottom and Bank Erosion for River Restoration after Dam Slit in the Mountain Stream

  • Kang, Ji-Hyun;So, Kazama
    • Proceedings of the Korea Water Resources Association Conference
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    • 2011.05a
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    • pp.46-46
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    • 2011
  • Severe sediment erosion during floods occur disaster and economic losses, but general sediment erosion is basic mechanism to move sediment from upstream to downstream river. In addition, it is important process to change river form. Check dam, which is constructed in mountain stream, play a vital role such as control of sudden debris flow, but it has negative aspects to river ecosystem. Now a day, check dam of open type is an alternative plan to recover river biological diversity and ecosystem through sediment transport while maintaining the function of disaster control. The purpose of this paper is to verify sediment erosion progress of river bottom and bank as first step for river restoration after dam slit by cross-sectional shear stress and critical shear stress. Study area is upstream reach of slit check dam in mountain stream, named Wasada, in Japan. The check dam was slit with two passages in August, 2010. The transects were surveyed for four upstream cross-sections, 7.4 m, 34 m, 86 m, and 150 m distance from dam in October 2010. Sediment size was surveyed at river bottom and bank. Sediment of cobble size was found at the wetted bottom, and small size particles of sand to medium gravel composed river bank. Discharge was $2.5\;m^3/s$ and bottom slope was 0.027 m/m. Excess shear stress (${\tau}_{ex}$) was calculated for hydraulic erosion by subtracting the values of critical shear stress (${\tau}_{c}$) from the value of shear stress (${\tau}$) at river bottom and bank (${\tau}_{ex}=\tau-{\tau}_c$). Shear stress of river bottom (${\tau}_{bottom}$) was calculated using the cross-sectional shear stress, and bank shear stress (${\tau}_{bank}$) was calculated from the method of Flintham and Carling (1988). $${\tau}_{bank}={\tau}^*SF_{bank}((B+P_{bed})/(2^*P_{bank}))$$ where $SF_{bank}=1.77(P_{bed}/p_{bank}+1.5)^{-1.4}$, B is the water surface width, $P_{bed}$ and $P_{bank}$ are wetted parameter of the bed and bank. Estimated values for ${\tau}_{bottom}$ for a flow of $2.5\;m^3/s$ were lower as 25.0 (7.5 m cross-section), 25.7 (34 m), 21.3 (86 m) and 19.8 (150 m), in N/$m^2$, than critical shear stress (${\tau}_c=62.1\;N/m^2$) with cobble of 64 mm. The values were insufficient to erode cobble sediment. In contrast, even if the values of ${\tau}_{bank}$ were lower than the values for ${\tau}_{bottom}$ as 18.7 (7.5 m), 19.3 (34 m), 16.1 (86 m) and 14.7 (150 m), in N/$m^2$, excess shear stresses were calculated at the three cross-sections of 7.5 m, 34 m, and 86 m distances compare with ${\tau}_c$ is 15.5 N/$m^2$ of 16mm gravel. Bank shear stresses were sufficient for erosion of the medium gravel to sand. Therefore there is potential to erode lateral bank than downward erosion in a flow of $2.5\;m^3/s$. Undercutting of the wetted bank can causes bank scour or collapse, therefore this channel has potential to become wider at the same time. This research is about a potential of sediment erosion, and the result could not verify with real data. Therefore it need next step for verification. In addition an erosion mechanism for river restoration is not simple because discharge distribution is variable by snow-melting or rainy season, and a function for disaster control will recover by big precipitation event. Therefore it needs to consider the relationship between continuous discharge change and sediment erosion.

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Research about a successful adopting for the CRM in the companies (기업에서의 성공적인 CRM 정착에 대한 연구)

  • Kim, Gipyoung
    • The Journal of Industrial Distribution & Business
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    • v.2 no.1
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    • pp.5-15
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    • 2011
  • Prior to the introduction of the CRM, we need to analyze the characteristics and the situations of the company, and should establish a clear vision of the CRM. And each company should identify elements and technologies for introducing the most suitable CRM for them, and optimize them, with long-term perspective. In addition, it requires the implementation strategy which integrates the existing company's routine marketing activities with the concept of the CRM. According to the implementation strategy, the company should improve the business process which is the most effective in investment step by step, and the information system strategy, which develops system investment gradually, should harmonize with it. First, we recognized that raising the company value is important by maximizing customer lifetime value (LTV) by understanding customer needs, and achieving the company's goal through customer satisfaction. Second, we understood that adopting the CRM should be accompanied by changes in the structure, business process and customer contact channels, and it can be successfully integrated with business when it gets proper understandings and attentions of the management. Third, the reality is that there are few cases of successful implementation of domestic companies, and some companies that successfully implement the system mean nothing but implement the solution for developing the CRM. Therefore, it needs to be observed for the long haul, and it seems that we need to approach more systematically to implementation cases for each industry about implementation of the CRM. Fourth, the CRM is no longer the preserve of major companies, and it is the time that medium and small sized enterprises also need it. Taking lesson from Switzerland's small size store merchants who successfully adopt right size of the CRM for their business, for domestic medium and small sized enterprises, the necessity to develop business through developing the CRM models which fit their situations and maintaining relationships with customers has been grown. Fifth, for adopting the CRM business processes, changing or converting the CRM system to the model which fits the company's situation is important rather than applying the advanced company's CRM system model. In other words, the CRM solution which can maximize their own strength by developing the CRM program that makes the most of features and characteristics of the company should be adopted.

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A study on optical coherence tomography system using optical fiber (광섬유를 이용한 광영상 단층촬영기에 관한연구)

  • 양승국;박양하;장원석;오상기;김현덕;김기문
    • Proceedings of the Korean Institute of Navigation and Port Research Conference
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    • 2004.04a
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    • pp.5-9
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    • 2004
  • In this paper, we studied the OCT(Optical Coherence Tomography) system which it has been extensively studied because of having some advantages such as high resolution cross-sectional images, low cost, and small size configuration. A basic principle of OCT system is Michelson interferometer. The characteristics of light source determine the resolution and the transmission depth. As a results, the light source have a commercial SLD with a central wavelength of 1,285 nm and FWHM(Full Width at Half Maximum) of 35.3 nm. The optical delay line part is necessary to equal of the optical path length with scattered light or reflected light from sample. In order to equal the optical path length, the stage which is attached to reference mirror is moved linearly by step motor And the interferometer is configured with the Michelson interferometer using single mod fiber, the scanner can be focused of the sample by using the reference arm. Also, the 2-dimensional cross-sectional images were measured with scanning the transverse direction of the sample by using step motor. After detecting the internal signal of lateral direction at a paint of sample, scanner is moved to obtain the cross-sectional image of 2-demensional by using step motor. Photodiode has been used which has high detection sensitivity, excellent noise characteristic, and dynamic range from 800 nm to 1,700 nm. It is detected mixed small signal between noise and interference signal with high frequency After filtering and amplifying this signal, only envelope curve of interference signal is detected. And then, cross-sectional image is shown through converting this signal into digitalized signal using A/D converter. The resolution of the OCT system is about 30$\mu\textrm{m}$ which corresponds to the theoretical resolution. Also, the cross-sectional image of ping-pong ball is measured. The OCT system is configured with Michelson interferometer which has a low contrast because of reducing the power of feedback interference light. Such a problem is overcomed by using the improved inteferometer. Also, in order to obtain the cross-sectional image within a short time, it is necessary to reduce the measurement time for improving the optical delay line.

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