• Journal of Hospice and Palliative Care
• /
• 제22권4호
• /
• pp.145-155
• /
• 2019

목적: 호스피스 완화의료에의 접근성 향상을 위해 요양병원을 호스피스 전문기관으로 지정하는 개정안이 최근 시행되었다. 호스피스 전문기관의 양적 증대도 중요하지만, 이러한 개정에 따른 서비스의 질적 저하 역시 충분히 고려되어야 한다. 이러한 관점에서 본 연구는 1,001명의 암환자, 1,006명의 가족 간병인, 928명의 의사 및 1,005명의 일반인이 해당 개정안이 가진 이점과 비용에 대해 어떻게 인식하고 있는지 확인하였다. 방법: 2016년 7월부터 10월까지 다기관 단면조사를 시행하였다. 연구 참여자들은 전문가 인터뷰 및 선행연구에서 추출된 본 개정안의 이점과 비용에 대해 각각 얼마나 동의 혹은 동의하지 않는지 응답하였다. 분석에는 카이제곱 분석, 단변량 및 다변량 로지스틱 회귀분석을 활용하였다. 결과: 참조집단인 일반인 집단과 비교했을 때, 의사 집단은 요양병원이 양질의 호스피스 완화의료 서비스를 제공하기 위한 시설 및 인력이 충분하지 않다는 점에 더 동의하였으나, 요양병원에서 과한 진료비를 청구할 것이라는 점에는 더 동의하지 않았다. 가족 간병인의 경우 일반인에 비해 요양병원에서 서비스를 제공한다면 접근성이 좋아질 것이라는 점에 더 동의했으나, 호스피스 정신이 훼손될 수 있음과 가족들이 환자 돌봄에 신경 쓰지 않을 것을 더 우려하였다. 일반인과 비교했을 때, 암환자 역시 마찬가지로 호스피스 정신이 훼손될 수 있음을 더 우려하였으며, 서비스의 질이 좋아질 것이라는 점에 대해서는 더 동의하지 않았다. 결론: 본 연구를 통해 호스피스 완화의료의 잠재적인 서비스 이용자 및 제공자가 해당 개정의 이점뿐만 아니라 비용 역시 인식하고 있음을 확인하였다. 본 연구 결과 및 유럽 국가들의 사례를 통해 개정안이 실제로 현장에서 실행되기 전에 호스피스 전문기관으로서 요양병원이 새롭게 갖추어야 할 요건 및 방향성에 대해 제언하였다.

• 지능정보연구
• /
• 제18권2호
• /
• pp.29-45
• /
• 2012

회사채 신용등급은 투자자의 입장에서는 수익률 결정의 중요한 요소이며 기업의 입장에서는 자본비용 및 기업 가치와 관련된 중요한 재무의사결정사항으로 정교한 신용등급 예측 모형의 개발은 재무 및 회계 분야에서 오랫동안 전통적인 연구 주제가 되어왔다. 그러나, 회사채 신용등급 예측 모형의 성과와 관련된 가장 중요한 문제는 등급별 데이터의 불균형 문제이다. 예측 문제에 있어서 데이터 불균형(Data imbalance) 은 사용되는 표본이 특정 범주에 편중되었을 때 나타난다. 데이터 불균형이 심화됨에 따라 범주 사이의 분류경계영역이 왜곡되므로 분류자의 학습성과가 저하되게 된다. 본 연구에서는 데이터 불균형 문제가 존재하는 다분류 문제를 효과적으로 해결하기 위한 다분류 기하평균 부스팅 기법 (Multiclass Geometric Mean-based Boosting MGM-Boost)을 제안하고자 한다. MGM-Boost 알고리즘은 부스팅 알고리즘에 기하평균 개념을 도입한 것으로 오분류된 표본에 대한 학습을 강화할 수 있으며 불균형 분포를 보이는 각 범주의 예측정확도를 동시에 고려한 학습이 가능하다는 장점이 있다. 회사채 신용등급 예측문제를 활용하여 MGM-Boost의 성과를 검증한 결과 SVM 및 AdaBoost 기법과 비교하여 통계적으로 유의적인 성과개선 효과를 보여주었으며 데이터 불균형 하에서도 벤치마킹 모형과 비교하여 견고한 학습성과를 나타냈다.

• 한국환경성돌연변이발암원학회지
• /
• 제22권3호
• /
• pp.142-148
• /
• 2002

Although ionizing radiation (IR) has been used to treat the various human cancers, IR is cytotoxic not only to cancer cells but to the adjacent normal tissue. Since normal tissue complications are the limiting factor of cancer radiotherapy, one of the major concerns of IR therapy is to maximize the cancer cell killing and to minimize the toxic side effects on the adjacent normal tissue. As an attempt to develop a method to monitor the degree of radiation exposure to normal tissues during radiotherapy, we investigated the transcriptional responses of human peripheral blood lymphocytes (PBL) following IR using cDNA microarray chip containing 1,221 (1.2 K) known genes. Since conventional radiotherapy is delivered at about 24 h intervals at 180 to 300 cGy/day, we analyzed the transcriptional responses ex-vivo irradiated human PBL at 200 cGy for 24 h-period. We observed and report on 1) a group of genes transiently induced early after IR at 2 h, 2) of genes induced after IR at 6 h, 3) of genes induced after IR at 24 h and on 4) a group of genes whose expression patters were not changed after IR. Since Biological consequences of IR involve generation of various reactive oxygen species (ROS) and thus oxidative stress induced by the ROS is known to damage normal tissues during radiotherapy, we further tested the temporal expression profiles of genes involved in ROS modulation by RT-PCR. Specific changes of 6 antioxidant genes were identified in irradiated PBL among 9 genes tested. Our results suggest the potential of monitoring post-radiotherapy changes in temporal expression profiles of a specific set of genes as a measure of radiation effects on normal tissues. This type of approach should yield more useful information when validated in in vivo irradiated PBL from the cancer patients.

• Nutrition Research and Practice
• /
• 제8권3호
• /
• pp.336-341
• /
• 2014

BACKGROUND/OBJECTIVE: It is expected that dairy products such as cheeses, which are the main source of cholesterol and saturated fat, may lead to the development or increase the risk of cardiovascular and metabolic diseases; however, the results of different studies are inconsistent. This study was conducted to assess the association between cheese consumption and cardiovascular risk factors in an Iranian adult population. SUBJECTS/METHODS: Information from the Isfahan Healthy Heart Program (IHHP) was used for this cross-sectional study with a total of 1,752 participants (782 men and 970 women). Weight, height, waist and hip circumference measurement, as well as fasting blood samples were gathered and biochemical assessments were done. To evaluate the dietary intakes of participants a validated food frequency questionnaire, consists of 49 items, was completed by expert technicians. Consumption of cheese was classified as less than 7 times per week and 7-14 times per week. RESULTS: Higher consumption of cheese was associated with higher C-Reactive Protein (CRP), apolipoprotein A and high density lipoprotein cholesterol (HDL-C) level but not with fasting blood sugar (FBS), total cholesterol, low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B. Higher consumption of cheese was positively associated with consumption of liquid and solid oil, grain, pulses, fruit, vegetable, meat and dairy, and negatively associated with Global Dietary Index. After control for other potential confounders the association between cheese intake and metabolic syndrome (OR: 0.81; 96%CI: 0.71-0.94), low HDL-C level (OR: 0.87; 96%CI: 0.79-0.96) and dyslipidemia (OR: 0.88; 96%CI: 0.79-0.98) became negatively significant. CONCLUSION: This study found an inverse association between the frequency of cheese intake and cardiovascular risk factors; however, further prospective studies are required to confirm the present results and to illustrate its mechanisms.

• The Plant Pathology Journal
• /
• 제36권4호
• /
• pp.305-313
• /
• 2020

Host shifting and host expansion of fungal plant pathogens increases the rate of emergence of new pathogens and the incidence of disease in various crops, which threaten global food security. Magnaporthe species cause serious disease in rice, namely rice blast disease, as well as in many alternative hosts, including wheat, barley, and millet. A severe outbreak of wheat blast due to Magnaporthe oryzae occurred recently in Bangladesh, after the fungus was introduced from South America, causing great loss of yield. This outbreak of wheat blast is of growing concern, because it might spread to adjacent wheat-producing areas. Therefore, it is important to understand the host range and population structure of M. oryzae and related species for determining the evolutionary relationships among Magnaporthe species and for managing blast disease in the field. Here, we collected isolates of M. oryzae and related species from various Poaceae species, including crops and weeds surrounding rice fields, in Korea and determined their phylogenetic relationships and host species specificity. Internal transcribed spacer-mediated phylogenetic analysis revealed that M. oryzae and related species are classified into four groups primarily including isolates from rice, crabgrass, millet and tall fescue. Based on pathogenicity assays, M. oryzae and related species can infect different Poaceae hosts and move among hosts, suggesting the potential for host shifting and host expansion in nature. These results provide important information on the diversification of M. oryzae and related species with a broad range of Poaceae as hosts in crop fields.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권15호
• /
• pp.6697-6704
• /
• 2015

Background: The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. Materials and Methods: A nationwide populationbased cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Results: Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. Conclusions: The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.

• 대한예방한의학회지
• /
• 제9권2호
• /
• pp.77-91
• /
• 2005

The purpose of this study is to examine the recognition of the student of oriental medical school on cooperative system between Oriental and Western medicine and to provide basic information for the development of oriental medicine. In order to look at the level of recognition on cooperative system between Oriental and Western medicine, from September 1st to 15th of 2005, this study had been conducted through personal interview and questionnaires to 600 students who were attending the Department of Oriental Medicine (in both prep and regular courses) in D University, located in the City of Daegu. The data has been analyzed using statistic program, the SPSS WIN 12.0. Statistical analysis tools used for this study were frequency analysis, cross-over analysis and the t-test. The results are as follows; The students of oriental medical school had relatively high level of recognition on the basic concept, interests, necessity and potential for cooperative system between Oriental and Western medicine. However, they had negative understandings on the issue of unification of the two medical systems and it's possibility in the future. The students were optimistic about possible merits of cooperative system between Oriental and Western medicine, especially in the field of rehabilitation. On the reasons for lack of development of cooperative system between Oriental and Western medicine, the students listed prejudices existing on both sides firstly, followed by their contrasting approach on human illness, lack of legal and institutional support system, the indifferences of doctors and indifferences of oriental medical doctors. In addition, students understood that the dualism existing in our current medical system is aggravating mutual distrust between the two sides, causing the confusion of patients on the choice of medical facilities, and raising their medical bills. Therefore, in order to vitalize collaboration between Oriental and Western medicine in new health care environment, the following measures should be needed decreasing the prejudices between the two medical spheres with open mind improving educational programs in Western and Oriental medical schools; promoting joint academic research or exchange programs between the schools, and increasing government effort to minimize legal and institutional restrictions cooperative system between Oriental and Western medicine.

• Korean Journal of Acupuncture
• /
• 제35권3호
• /
• pp.130-138
• /
• 2018

Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

• JSTS:Journal of Semiconductor Technology and Science
• /
• 제7권3호
• /
• pp.196-208
• /
• 2007

An analytical model is proposed for an optically controlled Metal Semiconductor Field Effect Transistor (MESFET), known as Optical Field Effect Transistor (OPFET) considering the diffusion fabrication process. The electrical parameters such as threshold voltage, drain-source current, gate capacitances and switching response have been determined for the dark and various illuminated conditions. The Photovoltaic effect due to photogenerated carriers under illumination is shown to modulate the channel cross-section, which in turn significantly changes the threshold voltage, drainsource current, the gate capacitances and the device switching speed. The threshold voltage $V_T$ is reduced under optical illumination condition, which leads the device to change the device property from enhancement mode to depletion mode depending on photon impurity flux density. The resulting I-V characteristics show that the drain-source current IDS for different gate-source voltage $V_{gs}$ is significantly increased with optical illumination for photon flux densities of ${\Phi}=10^{15}\;and\;10^{17}/cm^2s$ compared to the dark condition. Further more, the drain-source current as a function of drain-source voltage $V_{DS}$ is evaluated to find the I-V characteristics for various pinch-off voltages $V_P$ for optimization of impurity flux density $Q_{Diff}$ by diffusion process. The resulting I-V characteristics also show that the diffusion process introduces less process-induced damage compared to ion implantation, which suffers from current reduction due to a large number of defects introduced by the ion implantation process. Further the results show significant increase in gate-source capacitance $C_{gs}$ and gate-drain capacitance $C_{gd}$ for optical illuminations, where the photo-induced voltage has a significant role on gate capacitances. The switching time ${\tau}$ of the OPFET device is computed for dark and illumination conditions. The switching time ${\tau}$ is greatly reduced by optical illumination and is also a function of device active layer thickness and corresponding impurity flux density $Q_{Diff}$. Thus it is shown that the diffusion process shows great potential for improvement of optoelectronic devices in quantum efficiency and other performance areas.

• 한국지반신소재학회논문집
• /
• 제1권1호
• /
• pp.3-11
• /
• 2002

최근 매립지의 건설에 많은 부직포와 Geomembrane이 사용되고 있다. Geomembrane의 보호를 위한 부직포의 현장 포설시 교통하중에 의해 받는 영향을 평가하기 위해 실제 매립지 현장에서 대규모의 모의 복토층을 형성하여 부직포의 중량과 배수층으로 사용되는 골재의 종류에 따라 상부의 중장비 운전시 발생할 수 있는 인장강도의 변화와 신도변화를 실험하였다. 그 결과 저중량일 때 부직포 뿐 아니라, Geomembrane에 영향을 미치는 것을 확인하였다. 따라서 향후 지속적인 시험을 통하여 더욱 더 많은 사례와 실험 데이터를 갖는다면 실제 현장에서 Geomembrane을 포설 할 때 적용할 수 있는 합리적 기준이 마련될 수 있을 것으로 사료된다.