Efficacy and Accuracy of Patient Specific Customize Bolus Using a 3-Dimensional Printer for Electron Beam Therapy (전자선 빔 치료 시 삼차원프린터를 이용하여 제작한 환자맞춤형 볼루스의 유용성 및 선량 정확도 평가)
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- Progress in Medical Physics
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- v.27 no.2
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- pp.64-71
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- 2016
We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from
Thecodiplosis japonesis is sweeping the Pinus densiflora forests from south-west to north-east direction, destroying almost all the aged large trees as well as even the young ones. The front line of infestation is moving slowly but ceaselessly norhwards as a long bottle front. Estimation is that more than 40 percent of the area of P. densiflora forest has been damaged already, however some individuals could escapes from the damage and contribute to restore the site to the previous vegetation composition. When the stands were attacked by this insect, the drastic openings of the upper story of tree canopy formed by exclusively P. densiflora are usually resulted and some environmental factors such as light, temperature, litter accumulation, soil moisture and offers were naturally modified. With these changes after insect invasion, as the time passes, phytosociologic changes of the vegetation are gradually proceeding. If we select the forest according to four categories concerning the history of the insect outbreak, namely, non-attacked (healthy forest), recently damaged (the outbreak occured about 1-2 years ago), severely damaged (occured 5-6 years ago), damage prolonged (occured 10 years ago) and restored (occured about 20 years ago), any directional changes of vegetation composition could be traced these in line with four progressive stages. To elucidate these changes, three survey districts; (1) "Gongju" where the damage was severe and it was outbroken in 1977, (2) "Buyeo" where damage prolonged and (3) "Gochang" as restored, were set, (See Tab. 1). All these were located in the south temperate forest zone which was delimited mainly due to the temporature factor and generally accepted without any opposition at present. In view of temperature, the amount and distribution of precipitation and various soil factor, the overall homogeneity of environmental conditions between survey districts might be accepted. However this did not mean that small changes of edaphic and topographic conditions and microclimates can induce any alteration of vegetation patterns. Again four survey plots were set in each district and inter plot distance was 3 to 4 km. And again four subplots were set within a survey plot. The size of a subplot was
There are only a handful number of research conducted on pattern analysis of corporate distress as compared with research for bankruptcy prediction. The few that exists mainly focus on audited firms because financial data collection is easier for these firms. But in reality, corporate financial distress is a far more common and critical phenomenon for non-audited firms which are mainly comprised of small and medium sized firms. The purpose of this paper is to classify non-audited firms under distress according to their financial ratio using data mining; Self-Organizing Map (SOM). SOM is a type of artificial neural network that is trained using unsupervised learning to produce a lower dimensional discretized representation of the input space of the training samples, called a map. SOM is different from other artificial neural networks as it applies competitive learning as opposed to error-correction learning such as backpropagation with gradient descent, and in the sense that it uses a neighborhood function to preserve the topological properties of the input space. It is one of the popular and successful clustering algorithm. In this study, we classify types of financial distress firms, specially, non-audited firms. In the empirical test, we collect 10 financial ratios of 100 non-audited firms under distress in 2004 for the previous two years (2002 and 2003). Using these financial ratios and the SOM algorithm, five distinct patterns were distinguished. In pattern 1, financial distress was very serious in almost all financial ratios. 12% of the firms are included in these patterns. In pattern 2, financial distress was weak in almost financial ratios. 14% of the firms are included in pattern 2. In pattern 3, growth ratio was the worst among all patterns. It is speculated that the firms of this pattern may be under distress due to severe competition in their industries. Approximately 30% of the firms fell into this group. In pattern 4, the growth ratio was higher than any other pattern but the cash ratio and profitability ratio were not at the level of the growth ratio. It is concluded that the firms of this pattern were under distress in pursuit of expanding their business. About 25% of the firms were in this pattern. Last, pattern 5 encompassed very solvent firms. Perhaps firms of this pattern were distressed due to a bad short-term strategic decision or due to problems with the enterpriser of the firms. Approximately 18% of the firms were under this pattern. This study has the academic and empirical contribution. In the perspectives of the academic contribution, non-audited companies that tend to be easily bankrupt and have the unstructured or easily manipulated financial data are classified by the data mining technology (Self-Organizing Map) rather than big sized audited firms that have the well prepared and reliable financial data. In the perspectives of the empirical one, even though the financial data of the non-audited firms are conducted to analyze, it is useful for find out the first order symptom of financial distress, which makes us to forecast the prediction of bankruptcy of the firms and to manage the early warning and alert signal. These are the academic and empirical contribution of this study. The limitation of this research is to analyze only 100 corporates due to the difficulty of collecting the financial data of the non-audited firms, which make us to be hard to proceed to the analysis by the category or size difference. Also, non-financial qualitative data is crucial for the analysis of bankruptcy. Thus, the non-financial qualitative factor is taken into account for the next study. This study sheds some light on the non-audited small and medium sized firms' distress prediction in the future.
As distribution environment is changing rapidly and competition is more intensive in the channel of distribution, the importance of retailer image and retailer equity is increasing as a different competitive advantages. Also, consumers are not functionally oriented and that their behavior is significantly affected by the symbols such as retailer image which identify retailer in the market place. That is, consumers do not choose products or retailers for their material utilities but consume the symbolic meaning of those products or retailers as expressed in their self images. The concept of self-image congruence has been utilized by marketers and researchers as an aid in better understanding how consumers identify themselves with the brands they buy and the retailer they patronize. Although self-image congruity theory has been tested across many product categories, the theory has not been tested extensively in the retailing. Therefore, this study attempts to investigate the impact of self image congruence between retailer image and self image of consumer on retailer equity such as retailer awareness, retailer association, perceived retailer quality, and retailer loyalty. The purpose of this study is to find out whether retailer-self image congruence can be a new antecedent of retailer equity. In addition, this study tries to examine how four-dimensional retailer equity constructs (retailer awareness, retailer association, perceived retailer quality, and retailer loyalty) affect customers' repatronage intention. For this study, data were gathered by survey and analyzed by structural equation modeling. The sample size in the present study was 254. The reliability of the all seven dimensions was estimated with Cronbach's alpha, composite reliability values and average variance extracted values. We determined whether the measurement model supports the convergent validity and discriminant validity by Exploratory factor analysis and Confirmatory Factor Analysis. For each pair of constructs, the square root of the average variance extracted values exceeded their correlations, thus supporting the discriminant validity of the constructs. Hypotheses were tested using the AMOS 18.0. As expected, the image congruence hypotheses were supported. The greater the degree of congruence between retailer image and self-image, the more favorable were consumers' retailer evaluations. The all two retailer-self image congruence (actual self-image congruence and ideal self-image congruence) affected customer based retailer equity. This result means that retailer-self image congruence is important cue for customers to estimate retailer equity. In other words, consumers are often more likely to prefer products and retail stores that have images similar to their own self-image. Especially, it appeared that effect for the ideal self-image congruence was consistently larger than the actual self-image congruence on the retailer equity. The results mean that consumers prefer or search for stores that have images compatible with consumer's perception of ideal-self. In addition, this study revealed that customers' estimations toward customer based retailer equity affected the repatronage intention. The results showed that all four dimensions (retailer awareness, retailer association, perceived retailer quality, and retailer loyalty) had positive effect on the repatronage intention. That is, management and investment to improve image congruence between retailer and consumers' self make customers' positive evaluation of retailer equity, and then the positive customer based retailer equity can enhance the repatonage intention. And to conclude, retailer's image management is an important part of successful retailer performance management, and the retailer-self image congruence is an important antecedent of retailer equity. Therefore, it is more important to develop and improve retailer's image similar to consumers' image. Given the pressure to provide increased image congruence, it is not surprising that retailers have made significant investments in enhancing the fit between retailer image and self image of consumer. The enhancing such self-image congruence may allow marketers to target customers who may be influenced by image appeals in advertising.
Purpose: The purpose of this study is to evaluate the ovarian dose during radiation therapy for breast cancer in women of childbearing age through an experiment. The ovarian dose is evaluated by comparing and analyzing between the calculated dose in the treatment planning system according to the treatment technique and the measured dose using a thermoluminescence dosimeter (TLD). The clinical usefulness of lead (Pb) apron is investigated through dose analysis according to whether or not it is used. Materials and Methods: Rando humanoid phantom was used for measurement, and wedge filter radiation therapy, 3D conformal radiation therapy, and intensity modulated radiation therapy were used as treatment techniques. A treatment plan was established so that 95% of the prescribed dose could be delivered to the right breast of the Rando humanoid phantom 3D image obtained using the CT simulator. TLD was inserted into the surface and depth of the virtual ovary of the Rando hunmanoid phantom and irradiated with radiation. The measurement location was the center of treatment and the point moved 2 cm to the opposite breast from the center of the Rando hunmanoid phantom, 5cm, 10cm, 12.5cm, 15cm, 17.5cm, 20cm from the boundary of the right breast to the center of treatment and downward, and the surface and depth of the right ovary. Measurements were made at a total of 9 central points. In the dose comparison of treatment planning systems, two wedge filter treatment techniques, three-dimensional conformal radiotherapy, and intensity-modulated radiation therapy were established and compared. Treatments were compared, and dose measurements according to the use of lead apron were compared and analyzed in intensity-modulated radiation therapy. The measured value was calculated by averaging three TLD values for each point and converting using the TLD calibration value, which was calculated as the point dose mean value. In order to compare the treatment plan value with the actual measured value, the absolute dose value was measured and compared at each point (%Diff). Results: At Point A, the center of treatment, a maximum of 201.7cGy was obtained in the treatment planning system, and a maximum of 200.6cGy was obtained in the TLD. In all treatment planning systems, 0cGy was calculated from Point G, which is a point 17.5cm downward from the breast interface. As a result of TLD, a maximum of 2.6cGy was obtained at Point G, and a maximum of 0.9cGy was obtained at Point J, which is the ovarian dose, and the absolute dose was 0.3%~1.3%. The difference in dose according to the use of lead aprons was from a maximum of 2.1cGy to a minimum of 0.1cGy, and the %Diff value was 0.1%~1.1%. Conclusion: In the treatment planning system, the difference in dose according to the three treatment plans did not show a significant difference from 0.85% to 2.45%. In the ovary, the difference between the Rando humanoid phantom's treatment planning system and the actual measured dose was within 0.9%, and the actual measured dose was slightly higher. This did not accurately reflect the effect of scattered radiation in the treatment planning system, and it is thought that the dose of scattered radiation and the dose taken by CBCT with TLD inserted were reflected in the actual measurement. In dosimetry according to the with or without a lead apron, when a lead apron was used, the closer the distance from the treatment range, the more effective the shielding was. Although it is not clinically appropriate for pregnancy or artificial insemination during radiotherapy, the dose irradiated to the ovaries during treatment is not expected to significantly affect the reproductive function of women of childbearing age after radiotherapy. However, since women of childbearing age have constant anxiety, it is thought that psychological stability can be promoted by presenting the data from this study.
The overall study of Samsaebulhoedo (painting of the Assembly of Buddhas of Three Ages) at Yongjusa Temple has focused on dating it, analyzing the painting style, identifying its painter, and scrutinizing the related documents. However, its greater coherence could be achieved through additional support from empirical evidence and logical consistency. Recent studies on Samsaebulhoedo at Yongjusa Temple that postulate that the painting could have been produced by a monk-painter in the late nineteenth century and that an original version produced in 1790 could have been retouched by a painter in the 1920s using a Western painting style lack such empirical proof and logic. Although King Jeongjo's son was not yet installed as crown prince, the Samsaebulhoedo at Yongjusa Temple contained a conventional written prayer wishing for a long life for the king, queen, and crown prince: "May his majesty the King live long / May her majesty the Queen live long / May his highness the Crown Prince live long" (主上殿下壽萬歲, 王妃殿下壽萬歲, 世子邸下壽萬歲). Later, this phrase was erased using cinnabar and revised to include unusual content in an exceptional order: "May his majesty the King live long / May his highness the King's Affectionate Mother (Jagung) live long / May her majesty the Queen live long / May his highness the Crown Prince live long" (主上殿下壽萬歲, 慈宮邸下壽萬歲, 王妃殿下壽萬歲, 世子邸下壽萬歲). A comprehensive comparison of the formats and contents in written prayers found on late Joseon Buddhist paintings and a careful analysis of royal liturgy during the reign of King Jeongjo reveal Samsaebulhoedo at Yongjusa Temple to be an original version produced at the time of the founding of Yongjusa Temple in 1790. According to a comparative analysis of formats, iconography, styles, aesthetic sensibilities, and techniques found in Buddhist paintings and paintings by Joseon court painters from the eighteenth and nineteenth centuries, Samsaebulhoedo at Yongjusa Temple bears features characteristic of paintings produced around 1790, which corresponds to the result of analysis on the written prayer. Buddhist paintings created up to the early eighteenth century show deities with their sizes determined by their religious status and a two-dimensional conceptual composition based on the traditional perspective of depicting close objects in the lower section and distant objects above. This Samsaebulhoedo, however, systematically places the Buddhist deities within a threedimensional space constructed by applying a linear perspective. Through the extensive employment of chiaroscuro as found in Western painting, it expresses white highlights and shadows, evoking a feeling that the magnificent world of the Buddhas of the Three Ages actually unfolds in front of viewers. Since the inner order of a linear perspective and the outer illusion of chiaroscuro shading are intimately related to each other, it is difficult to believe that the white highlights were a later addition. Moreover, the creative convergence of highly-developed Western painting style and techniques that is on display in this Samsaebulhoedo could only have been achieved by late-Joseon court painters working during the reign of King Jeongjo, including Kim Hongdo, Yi Myeong-gi, and Kim Deuksin. Deungun, the head monk of Yongjusa Temple, wrote Yongjusa sajeok (History of Yongjusa Temple) by compiling the historical records on the temple that had been transmitted since its founding. In Yongjusa sajeok, Deungun recorded that Kim Hongdo painted Samsaebulhoedo as if it were a historical fact. The Joseon royal court's official records, Ilseongnok (Daily Records of the Royal Court and Important Officials) and Suwonbu jiryeong deungnok (Suwon Construction Records), indicate that Kim Hongdo, Yi Myeong-gi, and Kim Deuksin all served as a supervisor (gamdong) for the production of Buddhist paintings. Since within Joseon's hierarchical administrative system it was considered improper to allow court painters of government position to create Buddhist paintings which had previously been produced by monk-painters, they were appointed as gamdong in name only to avoid a political liability. In reality, court painters were ordered to create Buddhist paintings. During their reigns, King Yeongjo and King Jeongjo summoned the literati painters Jo Yeongseok and Kang Sehwang to serve as gamdong for the production of royal portraits and requested that they paint these portraits as well. Thus, the boundary between the concept of supervision and that of painting occasionally blurred. Supervision did not completely preclude painting, and a gamdong could also serve as a painter. In this light, the historical records in Yongjusa sajeok are not inconsistent with those in Ilseongnok, Suwonbu jiryeong deungnok, and a prayer written by Hwang Deok-sun, which was found inside the canopy in Daeungjeon Hall at Yongjusa Temple. These records provided the same content in different forms as required for their purposes and according to the context. This approach to the Samsaebulhoedo at Yongjusa Temple will lead to a more coherent explanation of dating the painting, analyzing its style, identifying its painter, and interpreting the relevant documents based on empirical grounds and logical consistency.
INTRODUCTION Due to the high broadband internet penetration rate and its group-oriented culture, various types of online communities operate in Korea. This study use 'Uses and Gratification Approach, and argue that members' usage-needs satisfaction with brand community is an important factor for promoting community commitment. Based on previous studies identifying the effect of brand image on consumers' responses to various marketing stimuli, this study hypothesizes that brand image can be a moderate variable affecting the relationship between usage-needs satisfaction with brand community and members' commitment to brand community. This study analyzes the influence of usage-needs satisfaction on brand community commitment and how apparel brand image affects the relationships between usage-needs satisfactions and community commitments. The hypotheses of this study are proposed as follows. H1-3: The usage-needs satisfaction of apparel brand community (interest, transaction, relationship needs) influences emotional (H1), continuous (H2), and normative (H3) commitments to apparel brand communities. H4-6: Apparel brand image has a moderating effect on the relationship between usage-needs satisfaction and emotional (H4), continuous (H5), and normative (H6) commitments to apparel brand communities. METHODS Brand communities founded by non-company affiliates were excluded and emphasis was placed instead on communities created by apparel brand companies. Among casual apparel brands registered in 6 Korean portal sites in August 2003, a total of 9 casual apparel brand online communities were chosen, depending on the level of community activity and apparel brand image. Data from 317 community members were analyzed by exploratory factor analysis, moderated regression analysis, ANOVA, and scheffe test. Among 317 respondents answered an online html-type questionnaire, 80.5% were between 16 to 25 years old. There were a total of 150 respondents from apparel brand communities(n=3) recording higher-than-average brand image scores (Mean > 3.75) and a total of 162 respondents from apparel brand communities(n=6) recording lower-than-average brand image scores(Mean < 3.75). In this study, brand community commitment was measured by a 5-point Likert scale: emotional, continuous and normative commitment. The degree of usage-needs satisfaction (interest, transaction, relationship needs) was measured on a 5-point Likert scale. The level of brand image was measured by a 5-point Likert scale: strength, favorability, and uniqueness of brand associations. RESULTS In the results of exploratory factor analysis, the three usage-needs satisfactions with brand community were classified as interest, transaction, and relationship needs. Brand community commitment was also divided into the multi-dimensional factors: emotional, continuous, and normative commitments. The regression analysis (using a stepwise method) was used to test the influence of 3 independent variables (interest-needs satisfaction, transaction-needs, and relationship-needs satisfactions) on the 3 dependent variables (emotional, continuous and normative commitments). The three types of usage-needs satisfactions are positively associated with the three types of commitments to apparel brand communities. Therefore, hypothesis 1, 2, and 3 were significantly supported. Moderating effects of apparel brand image on the relationship between usage-needs satisfaction and brand community commitments were tested by moderated regression analysis. The statistics result showed that the influence of transaction-needs on emotional commitment was significantly moderated by apparel brand image. In addition, apparel brand image had moderating effects on the relationship between relationship-needs satisfaction and emotional, continuous and normative commitments to apparel brand communities. However, there were not significant moderate effects of apparel brand image on the relationships between interest-needs satisfaction and 3 types of commitments (emotional, continuous and normative commitments) to apparel brand communities. In addition, the influences of transaction-needs satisfaction on 2 types of commitments (continuous and normative commitments) were not significantly moderated by apparel brand image. Therefore, hypothesis 4, 5 and 6 were partially supported. To explain the moderating effects of apparel brand image, four cross-tabulated groups were made by averages of usage-needs satisfaction (interest-needs satisfaction avg. M=3.09, transaction-needs satisfaction avg. M=3.46, relationship-needs satisfaction M=1.62) and the average apparel brand image (M=3.75). The average scores of commitments in each classified group are presented in Tables and Figures. There were significant differences among four groups. As can be seen from the results of scheffe test on the tables, emotional commitment in community group with high brand image was higher than one in community group with low brand image when transaction-needs satisfaction was high. However, when transaction-needs satisfaction was low, there was not any difference between the community group with high brand image and community group with low brand image regarding emotional commitment to apparel brand communities. It means that emotional commitment didn't increase significantly without high satisfaction of transaction-needs, despite the high apparel brand image. In addition, when apparel brand image was low, increase in transaction-needs did not lead to the increase in emotional commitment. Therefore, the significant relationship between transaction-needs satisfaction and emotional commitment was found in only brand communities with high apparel brand image, and the moderating effect of apparel brand image on this relationship between two variables was found in the communities with high satisfaction of transaction-needs only. Statistics results showed that the level of emotional commitment is related to the satisfaction level of transaction-needs, while overall response is related to the level of apparel brand image. We also found that the role of apparel brand image as a moderating factor was limited by the level of transaction-needs satisfaction. In addition, relationship-needs satisfaction brought significant increase in emotional commitment in both community groups (high and low levels of brand image), and the effect of apparel brand image on emotional commitment was significant in both community groups (high and low levels of relationship-needs satisfaction). Especially, the effect of brand image was greater when the level of relationship-needs satisfaction was high. in contrast, increase in emotional commitment responding to increase in relationship-needs satisfaction was greater when apparel brand image is high. The significant influences of relationship-needs satisfaction on community commitments (continuous and normative commitments) were found regardless of apparel brand image(in both community groups with low and high brand image). However, the effects of apparel brand image on continuous and normative commitments were found in only community group with high satisfaction level of relationship-needs. In the case of communities with low satisfaction levels of relationship needs, apparel brand image marginally increases continuous and normative commitments. Therefore, we could not find the moderating effect of apparel brand image on the relationship between relationship-needs satisfaction and continuous and normative commitments in community groups with low satisfaction levels of relationship needs, CONCLUSIONS AND IMPLICATIONS From the results of this study, we draw several conclusions; First, the increases in usage-needs satisfactions through apparel brand communities result in the increases in commitments to apparel brand communities, wheres the degrees of such relationship depends on the level of apparel brand image. That is, apparel brand image is a moderating factor strengthening the relationship between usage-needs satisfaction and commitment to apparel brand communities. In addition, the effect of apparel brand image differs, depending on the level and types of community usage-needs satisfactions. Therefore, marketers of apparel brand companies must determine the appropriate usage-needs, depending on the type of commitment they wish to increase and the level of their apparel brand image, to promote member's commitments to apparel brand communities. Especially, relationship-needs satisfaction was very important factor for increasing emotional, continuous and normative commitments to communities. However the level of relationship-needs satisfaction was lower than interest-needs and transaction-needs. satisfaction. According to previous study on apparel brand communities, relationship-need satisfaction was strongly related to member's intention of participation in their communities. Therefore, marketers need to develope various strategies in order to increase the relationship- needs as well as interest and transaction needs. In addition, despite continuous commitment was higher than emotional and normative commitments, all types of commitments to apparel brand communities had scores lower than 3.0 that was mid point in 5-point scale. A Korean study reported that the level of members' commitment to apparel brand community influenced customers' identification with a brand and brand purchasing behavior. Therefore, marketers should try to increase members' usage-needs satisfaction and apparel brand image as the necessary conditions for bringing about community commitments. Second, marketers should understand that they should keep in mind that increasing the level of community usage needs (transaction and relationship) is most effective in raising commitment when the level of apparel brand image is high, and that increasing usage needs (transaction needs) satisfaction in communities with low brand image might not be as effective as anticipated. Therefore, apparel companies with desirable brand image such as luxury designer goods firms need to create formal online brand communities (as opposed to informal communities with rudimentary online contents) to satisfy transaction and relationship needs systematically. It will create brand equity through consumers' increased emotional, continuous and normative commitments. Even though apparel brand is very famous, emotional commitment to apparel brand communities cannot be easily increased without transaction-needs satisfaction. Therefore famous fashion brand companies should focus on developing various marketing strategies to increase transaction-needs satisfaction.