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Blood Gas Analysis of Respiratory Depression during Sevoflurane Inhalation Induction for General Anesthesia in the Disabled Patients (장애 환자의 전신 마취를 위한 세보플루란 흡입 유도 시 발생한 호흡 저하의 혈액 가스 분석)

  • Yoon, Taewan;Kim, Seungoh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.4
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    • pp.508-513
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    • 2018
  • Tidal volume by sevoflurane in small amounts is stable due to the increase in the breathing rate. But alveolus ventilation decreases due to sevoflurane as the degree of sedation increases; this ultimately causes $PaCO_2$ to rise. The occurrence of suppression of breath increases the risk of severe hypoxia and hypercapnia in deeply sedated patients with disabilities. Sevoflurane inhalation anesthesia has a number of risks and may have unexpected problems with hemodynamic changes depending on the underlying state of the body. This study was conducted to examine the stability of internal acid-base system caused by respiratory depression occurring when patients with disabilities are induced by sevoflurane. Anesthetic induction was carried out by placing a mask on top of the patient's face and through voluntary breathing with 4 vol% of sevoflurane, 4 L/min of nitrous oxide, and 4 L/min of oxygen. After the patient's loss of consciousness and muscle relaxation, IV line was inserted by an expert and intravenous blood gas was analyzed by extracting blood from vein. In a deeply sedated state, the average amount of pH of the entire patients was measured as $7.36{\pm}0.06$. The average amount of $PvCO_2$ of the entire patients was measured as $48.8{\pm}8.50mmHg$. The average amount of $HCO_3{^-}$ of the entire patients was measured as $27.2{\pm}3.0mmol/L$. In conclusion, in dental treatment of patients with disabilities, the internal acid base response to inhalation sedation using sevoflurane is relatively stable.

A Comparative Study of Machine Learning Algorithms Based on Tensorflow for Data Prediction (데이터 예측을 위한 텐서플로우 기반 기계학습 알고리즘 비교 연구)

  • Abbas, Qalab E.;Jang, Sung-Bong
    • KIPS Transactions on Computer and Communication Systems
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    • v.10 no.3
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    • pp.71-80
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    • 2021
  • The selection of an appropriate neural network algorithm is an important step for accurate data prediction in machine learning. Many algorithms based on basic artificial neural networks have been devised to efficiently predict future data. These networks include deep neural networks (DNNs), recurrent neural networks (RNNs), long short-term memory (LSTM) networks, and gated recurrent unit (GRU) neural networks. Developers face difficulties when choosing among these networks because sufficient information on their performance is unavailable. To alleviate this difficulty, we evaluated the performance of each algorithm by comparing their errors and processing times. Each neural network model was trained using a tax dataset, and the trained model was used for data prediction to compare accuracies among the various algorithms. Furthermore, the effects of activation functions and various optimizers on the performance of the models were analyzed The experimental results show that the GRU and LSTM algorithms yields the lowest prediction error with an average RMSE of 0.12 and an average R2 score of 0.78 and 0.75 respectively, and the basic DNN model achieves the lowest processing time but highest average RMSE of 0.163. Furthermore, the Adam optimizer yields the best performance (with DNN, GRU, and LSTM) in terms of error and the worst performance in terms of processing time. The findings of this study are thus expected to be useful for scientists and developers.

A Study on Effects of the Transient Compression by Tightly Tied Necktie on Blood Flow in the Internal Jugular Veins Using 2D-PC MRA (2D-PC MRA를 이용한 넥타이의 순간적인 압박(壓迫)이 내경정맥의 혈류에 미치는 영향에 대한 연구(硏究))

  • Kim, Keung-Sik;Chung, Tae-Sub;Park, In-Kook;Lee, Bum-Soo;Kim, Hyun-Soo;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.267-276
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    • 2008
  • The 25 healthy male volunteers aged from 20 to 50years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24cm FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie. The average of maximum velocity of internal carotid arteries without a necktie was 72.13cm/sec in the right side and 74.96cm/sec in the left side(average 73.54cm/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45cm/sec in the right side and -24.99cm/sec in the left side (-29.72cm/sec in both sides). However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35cm/sec in the right side and 65.19cm/sec in the left side(average 63.27cm/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14cm/sec in the right side and -17.93cm/sec in the left side(-20.03cm/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreased to 86% (63.27/73.54cm/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 cm/sec). Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins(33% decrease in blood flow speed) more significantly than that of internal carotid artery(14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers. In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

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Annotation Method based on Face Area for Efficient Interactive Video Authoring (효과적인 인터랙티브 비디오 저작을 위한 얼굴영역 기반의 어노테이션 방법)

  • Yoon, Ui Nyoung;Ga, Myeong Hyeon;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.21 no.1
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    • pp.83-98
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    • 2015
  • Many TV viewers use mainly portal sites in order to retrieve information related to broadcast while watching TV. However retrieving information that people wanted needs a lot of time to retrieve the information because current internet presents too much information which is not required. Consequentially, this process can't satisfy users who want to consume information immediately. Interactive video is being actively investigated to solve this problem. An interactive video provides clickable objects, areas or hotspots to interact with users. When users click object on the interactive video, they can see additional information, related to video, instantly. The following shows the three basic procedures to make an interactive video using interactive video authoring tool: (1) Create an augmented object; (2) Set an object's area and time to be displayed on the video; (3) Set an interactive action which is related to pages or hyperlink; However users who use existing authoring tools such as Popcorn Maker and Zentrick spend a lot of time in step (2). If users use wireWAX then they can save sufficient time to set object's location and time to be displayed because wireWAX uses vision based annotation method. But they need to wait for time to detect and track object. Therefore, it is required to reduce the process time in step (2) using benefits of manual annotation method and vision-based annotation method effectively. This paper proposes a novel annotation method allows annotator to easily annotate based on face area. For proposing new annotation method, this paper presents two steps: pre-processing step and annotation step. The pre-processing is necessary because system detects shots for users who want to find contents of video easily. Pre-processing step is as follow: 1) Extract shots using color histogram based shot boundary detection method from frames of video; 2) Make shot clusters using similarities of shots and aligns as shot sequences; and 3) Detect and track faces from all shots of shot sequence metadata and save into the shot sequence metadata with each shot. After pre-processing, user can annotates object as follow: 1) Annotator selects a shot sequence, and then selects keyframe of shot in the shot sequence; 2) Annotator annotates objects on the relative position of the actor's face on the selected keyframe. Then same objects will be annotated automatically until the end of shot sequence which has detected face area; and 3) User assigns additional information to the annotated object. In addition, this paper designs the feedback model in order to compensate the defects which are wrong aligned shots, wrong detected faces problem and inaccurate location problem might occur after object annotation. Furthermore, users can use interpolation method to interpolate position of objects which is deleted by feedback. After feedback user can save annotated object data to the interactive object metadata. Finally, this paper shows interactive video authoring system implemented for verifying performance of proposed annotation method which uses presented models. In the experiment presents analysis of object annotation time, and user evaluation. First, result of object annotation average time shows our proposed tool is 2 times faster than existing authoring tools for object annotation. Sometimes, annotation time of proposed tool took longer than existing authoring tools, because wrong shots are detected in the pre-processing. The usefulness and convenience of the system were measured through the user evaluation which was aimed at users who have experienced in interactive video authoring system. Recruited 19 experts evaluates of 11 questions which is out of CSUQ(Computer System Usability Questionnaire). CSUQ is designed by IBM for evaluating system. Through the user evaluation, showed that proposed tool is useful for authoring interactive video than about 10% of the other interactive video authoring systems.

A Study on Kiosk Satisfaction Level Improvement: Focusing on Kano, Timko, and PCSI Methodology (키오스크 소비자의 만족수준 연구: Kano, Timko, PCSI 방법론을 중심으로)

  • Choi, Jaehoon;Kim, Pansoo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.193-204
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    • 2022
  • This study analyzed the degree of influence of measurement and improvement of customer satisfaction level targeting kiosk users. In modern times, due to the development of technology and the improvement of the online environment, the probability that simple labor tasks will disappear after 10 years is close to 90%. Even in domestic research, it is predicted that 'simple labor jobs' will disappear due to the influence of advanced technology with a probability of about 36%. there is. In particular, as the demand for non-face-to-face services increases due to the Corona 19 virus, which is recently spreading globally, the trend of introducing kiosks has accelerated, and the global market will grow to 83.5 billion won in 2021, showing an average annual growth rate of 8.9%. there is. However, due to the unmanned nature of these kiosks, some consumers still have difficulties in using them, and consumers who are not familiar with the use of these technologies have a negative attitude towards service co-producers due to rejection of non-face-to-face services and anxiety about service errors. Lack of understanding leads to role conflicts between sales clerks and consumers, or inequality is being created in terms of service provision and generations accustomed to using technology. In addition, since kiosk is a representative technology-based self-service industry, if the user feels uncomfortable or requires additional labor, the overall service value decreases and the growth of the kiosk industry itself can be suppressed. It is important. Therefore, interviews were conducted on the main points of direct use with actual users centered on display color scheme, text size, device design, device size, internal UI (interface), amount of information, recognition sensor (barcode, NFC, etc.), Display brightness, self-event, and reaction speed items were extracted. Afterwards, using the questionnaire, the Kano model quality attribute classification of each expected evaluation item was carried out, and Timko's customer satisfaction coefficient, which can be calculated with accurate numerical values The PCSI Index analysis was additionally performed to determine the improvement priorities by finally classifying the improvement impact of the kiosk expected evaluation items through research. As a result, the impact of improvement appears in the order of internal UI (interface), text size, recognition sensor (barcode, NFC, etc.), reaction speed, self-event, display brightness, amount of information, device size, device design, and display color scheme. Through this, we intend to contribute to a comprehensive comparison of kiosk-based research in each field and to set the direction for improvement in the venture industry.

암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • Jo, In-Hyang
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL) (필리핀 결혼이민여성의 한식 섭취실태 및 한식 섭취율에 따른 사회경제학적 요인)

  • Kim, Nayeon;Kang, Minji;Abris, Grace;Provido, Sherlyn Mae P.;Joung, Hyojee;Hong, Sangmo;Yu, Sung Hoon;Lee, Chang Beom;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.23 no.6
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    • pp.475-487
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    • 2018
  • Objectives: This study examined the consumption of Han-sik and its association with the years of residence in Korea and the socioeconomic status among Filipino immigrant women of the Filipino Women's Diet and Health Study (FiLWHEL). Methods: A total of 474 Filipino women married to Korean men were included in the analysis. Their dietary intake was assessed using a single-day 24-hour recall. The participants provided information on the demographics, socioeconomic, and health-related factors through face-to-face interviews. The generalized linear model and logistic regression model were used to examine the association between the socioeconomic status and consumption of Han-sik. Results: The mean age of the participants was 34.3 years old, and the average duration of residence in Korea was 8.2 years. Among 474 Filipino women, a total of 467 consumed Han-sik, with an average of 6.8 food items per day. The Han-sik foods that the participants consumed most frequently were rice, cabbage kimchi, mixed-grain rice, and fried eggs. The average ratio of Han-sik was 58.57%. The ratio of Han-sik showed no significant associations with the years of residence, years of living together with their husband, education levels, total annual family income, or linguistic competence of Korean. However, the ratio of Han-sik use was associated with cohabitation with parents-in-law; the odds ratio (95% confidence interval) was 2.41 (1.18-4.92, p-trend = 0.002) comparing the fourth quartile with the first quartile of the Han-sik ratio. Conclusions: Filipino immigrant women in the FiLWHEL study consumed a larger number of Han-sik than Philippine foods. In addition, cohabitation with their parents-in-law was associated with the consumption of Han-sik. Further epidemiologic studies will be needed to determine how the diet affects the health and wellbeing of immigrant women in Korea.

Application and Evaluation of a Dietary Education Program for Korean Young Adults in Single-Person Households (청년 1인가구를 위한 식생활교육 프로그램 적용 및 평가)

  • Joung, Se Ho;Lee, Jung Woo;Kim, Ja Mee;Kim, Yookyung
    • Journal of Korean Home Economics Education Association
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    • v.33 no.3
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    • pp.143-157
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    • 2021
  • This study analyzed and verified the effects of a dietary education program for Korean young adults in single-person households. The dietary education program was conducted for five weeks (from November 10 to December 8, 2020) for Korean young adults in single-person households living in Seongbuk-gu, via four face-to-face education sessions and one online education session, including both theoretical lectures and practice. The effect of the dietary education program was analyzed through the Nutrition Quotient (NQ) questionnaire for adults provided by the Korean Nutrition Society, a dietary evaluation checklist questionnaire developed by the researchers, and photovoices. The average of 'Nutrition' score increased from 51.81 to 53.20, but there was no statistically significant difference. However, there was a significant change in the 'Moderation' category (p<0.05). As for the researcher-developed dietary evaluation, the average of the 'Importance' area rose from 3.77 to 3.99, but there was no statistically significant difference. The average of the 'Practice' area rose from 3.03 to 3.57, significant results were found (p<0.05). When the pre-/post-tests were compared by the sub-categories, four elements of 'Importance', i.e., balanced meals and avoided foods, and all five elements of 'Practice' were significantly improved (p<0.05). A total of 200 photovoices were analyzed according to Social Cognitive Theory. As a result of the analysis, the deterrents that help people eat healthy homemade food were 48% environmental factors, 30% behavioral factors, and 22% individual cognitive factors. The deterrents found to hinder participants from eating healthy homemade food were 72% environmental factors and 14% individual cognitive and behavioral factors. The results suggest that the dietary education program for Korean young adults in single-person households can be an effective tool that promotes self-motivation, behavioral changes, and improvements of the surrounding environment.

Medication Errors in Chemotherapy Preparation and Administration: a Survey Conducted among Oncology Nurses in Turkey

  • Ulas, Arife;Silay, Kamile;Akinci, Sema;Dede, Didem Sener;Akinci, Muhammed Bulent;Sendur, Mehmet Ali Nahit;Cubukcu, Erdem;Coskun, Hasan Senol;Degirmenci, Mustafa;Utkan, Gungor;Ozdemir, Nuriye;Isikdogan, Abdurrahman;Buyukcelik, Abdullah;Inanc, Mevlude;Bilici, Ahmet;Odabasi, Hatice;Cihan, Sener;Avci, Nilufer;Yalcin, Bulent
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1699-1705
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    • 2015
  • Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

A National Survey on Utilization of Pattern Identification among Korean Medicine Doctors (전국 한방의료기관 한의사 대상 한의 변증활용 현황 조사)

  • Yeo, Minkyung;Park, Kihyun;Jang, Eunsu;Lee, Youngseop
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.45-55
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    • 2015
  • Objective : The aim of this study was to survey the present utilization of pattern identification(PI) in the clinical field among Korean Medicine Doctors. Method : This survey was conducted from Oct. 1 to Oct. 31, 2014 by face-to-face interview using structured questionnaire. The subjects were 400 korean medicine doctors who worked in hospitals or clinics. The questionnaire consisted of two sections - a demographics section(i.e., sex, age, clinical experience, place of work, residence and so on) and the main research section(i.e., the PI utilization rate, the utilization of PI systems, the utilization of PI in the clinical domain and in the treatment domain, the correlation between utilization PI and so on). Results : This study revealed that subjects used the PI to 66.7% of their patients on average. The utilization rate of PI in patients was significantly higher for female physicians than for male physicians, for physicians worked in clinics than for physicians who worked in hospitals and for physicians with more than 10 years clinical experience than for physicians with less than 10 years clinical experience. In the utilization of PI systems, Visceral PI was most as 92.0%. There were significant difference on the PI utilization rate according to utilization of Meridian and Collateral PI, Triple Energizer PI, Defense, Qi, Nutrient and Blood PI, Six-Meridian PI and Six Excesses PI. As a result of analysing the PI utilization rate by clinical domain and in the treatment domain, the Treatment and the Drug Treatment showed the highest values. Among utilized PI systems, the correlation coefficients between Defense, Qi, Nutrient and Blood PI and Triple Energizer PI showed the highest value, but the correlation coefficients between Sasang Constitutional Medicine with the each PI showed substantially lower value. Conclusion : The results of this study demonstrate that usage of PI was higher than usage of U code(in KCD) usage in clinical field. we suggested that additional studies on using PI and developing more appropriate standardized tool should be conducted to widen scope of PI's utilization.