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Distress and Associated Factors in Patients with Breast Cancer Surgery : A Cross-Sectional Study (유방암 수술환자의 디스트레스 및 연관인자 : 단면연구)

  • Lee, Sang-Shin;Rim, Hyo-Deog;Woo, Jungmin
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.77-85
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    • 2018
  • Objectives : This study aimed to investigate the level of distress using the distress thermometer (DT) and the factors associated with distress in postoperative breast cancer (BC) patients. Methods : DT and WHOQOL-BREF (World Health Organization Quality of Life Scale Abbreviated Version) along with sociodemographic variables were assessed in patients undergoing surgery for their first treatment of BC within one week postoperatively. The distress group consisted of participants with a DT score ${\geq}4$. The prevalence and associative factors of distress were examined by descriptive, univariable, and logistic regression analysis. Results : Three hundred seven women were recruited, and 264 subjects were finally analyzed. A total of 173 (65.5%) were classified into the distress group. The distress group showed significantly younger age (p=0.045), living without a spouse (p=0.032), and worse quality of life (QOL) as measured by overall QOL (p=0.009), general health (p=0.005), physical health domain (p<0.000), and psychological health domain (p=0.002). The logistic regression analysis showed that patients aged 40-49 years were more likely to experience distress than those aged ${\geq}60years$ (Odds ratios [OR]=2.992, 95% confidence interval [CI] 1.241-7.215). Moreover, the WHOQOL-BREF physical health domain was a predictive factor of distress (OR=0.777, 95% CI 0.692-0.873). Conclusions : A substantial proportion of patients are experiencing significant distress after BC surgery. It would be expected that distress management, especially in the middle-aged patients and in the domain of physical QOL (e.g., pain, insomnia, fatigue), from the early BC treatment stage might reduce chronic distress.

A Preliminary Study on Domestic Embracement and Development Plan Regarding UNESCO World Heritage Programme (유네스코 세계유산 제도의 우리나라 문화재 정책에의 수용과 발전방안에 대한 시론적 연구)

  • Kang, Kyung Hwan;Kim, Chung Dong
    • Korean Journal of Heritage: History & Science
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    • v.43 no.1
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    • pp.56-85
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    • 2010
  • UNESCO World Heritage Programme was introduced following the adoption of Convention Concerning the Protection of the World Cultural and Natural Heritage by the General Conference of UNESCO in 1972 in order to protect cultural and natural heritage with superb value for all mankind. Despite its short history of less than 40 years, it has been evaluated as one of the most successful of the cultural area projects of UNESCO with 890 world heritage registered worldwide. For systematic protection management of World Heritage, UNESCO, through systemization of registration, emphasis on the importance of preservation management plan, institutionalization of monitoring, and operation of World Heritage Fund, has utilized World Heritage Programme not just as a means of listing excellent cultural properties, but as a preservation planning tool, and accordingly, such policies have had a significant influence on the cultural heritage protection legislations of numerous nations. Korea has ratified World Heritage Convention in 1988, and with the registration of the Royal Tombs of the Joseon Dynasty in 2009, it has 9 World Heritage Sites. Twenty years have passed since Korea joined the World Heritage Programme. While World Heritage registration contributed to publicity of the uniqueness and excellence of Korean cultural properties and improvement of Korea's national culture status, it is now time to devise various legislative/systematic improvement means to reconsider the World Heritage registration strategy and establish a systematic preservation management system. While up until now, the Cultural Properties Protection Law has been amended to arrange for basic rules regarding registration and protection of World Heritage Sites, and some local governments have founded bodies exclusive for World Heritage Site management, a more fundamental and macroscopic plan for World Heritage policy improvement must be sought. Projects and programs in each area for reinforcement of World Heritage policy capacity such as: 1) Enactment of a special law for World Heritage Site preservation management; 2) enactment of ordinances for protection of World Heritage Sites per each local government; 3) reinforcement of policies and management functionality of Cultural Heritage Administration and local governments; 4) dramatic increase in the finances of World Heritage Site protection; 5) requirement to establish plan for World Heritage Site preservation protection; 6) increased support for utilization of World Heritage Sites; 7) substantiation and diversification of World Heritage registration; 8) sharing of information and experiences of World Heritage Sites management among local governments; 9) installation of World Heritage Sites integral archive; 10) revitalization of citizen cooperation and resident participation; 11) training specialized resources for World Heritage Sites protection; 12) revitalization of sustainable World Heritage Sites tourism, must be selected and promoted systematically. Regarding how World Heritage Programme should be domestically accepted and developed, the methods for systemization, scientific approach, and specialization of World Heritage policies were suggested per type. In the future, in-depth and specialized researches and studies should follow.

Validation of Electronic Foot Function Index in Patients with Foot and Ankle Disease: A Randomized, Prospective Multicenter Study (족부 족관절 질환 환자에서 전자식 족부 기능 지수의 인증: 임의 배정, 전향적, 다기관 연구)

  • Lee, Dong Yeon;Kim, Yu Mi;Lee, Jun Hyung;Kim, Jin;Kim, Ji-Beom;Kim, Bom Soo;Choi, Gi Won;Seo, Sang Gyo;Kim, Jun Beom;Park, Se-Jin;Kim, Yoon-Chung;Choi, Young Rak;Lee, Dong-Oh;Cho, Jae-Ho;Chun, Dong-Il;Kim, Hyong Nyun;Park, Jae-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.24-30
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    • 2019
  • Purpose: To evaluate the efficiency of the electronic foot function index (eFFI) through a prospective, random based, multi-institutional study. Materials and Methods: The study included 227 patients ranging in age from 20 to 79 years, visited for surgery in different 15 institutes, and agreed to volunteer. The patients were assigned randomly into a paper-based evaluated group (n=113) and tablet-based evaluated group (n=114). The evaluation was done on the day of hospital admission and the method was changed on the second day of surgery and re-evaluated. PADAS 2.0 (https://www.proscore.kr) was used as an electronic evaluation program. Results: There were no differences in age and sex in both groups. The intraclass correlation coefficient (ICC) evaluation revealed an eFFI ICC of 0.924, showing that both results were similar. The evaluation time was shorter in the tablet-based group than the paper-based group (paper vs tablet, $3.7{\pm}3.8$ vs $2.3{\pm}1.3minutes$). Thirty-nine patients (17.2%) preferred to use paper and 131 patients (57.7%) preferred the tablet. Fifty-seven patients (25.1%) found both ways to be acceptable. Conclusion: eFFI through tablet devices appears to be more constant than the paper-based program. In addition, it required a shorter amount of time and the patients tended to prefer the tablet-based program. Overall, tablet and cloud system can be beneficial to a clinical study.

Development Process for User Needs-based Chatbot: Focusing on Design Thinking Methodology (사용자 니즈 기반의 챗봇 개발 프로세스: 디자인 사고방법론을 중심으로)

  • Kim, Museong;Seo, Bong-Goon;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.25 no.3
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    • pp.221-238
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    • 2019
  • Recently, companies and public institutions have been actively introducing chatbot services in the field of customer counseling and response. The introduction of the chatbot service not only brings labor cost savings to companies and organizations, but also enables rapid communication with customers. Advances in data analytics and artificial intelligence are driving the growth of these chatbot services. The current chatbot can understand users' questions and offer the most appropriate answers to questions through machine learning and deep learning. The advancement of chatbot core technologies such as NLP, NLU, and NLG has made it possible to understand words, understand paragraphs, understand meanings, and understand emotions. For this reason, the value of chatbots continues to rise. However, technology-oriented chatbots can be inconsistent with what users want inherently, so chatbots need to be addressed in the area of the user experience, not just in the area of technology. The Fourth Industrial Revolution represents the importance of the User Experience as well as the advancement of artificial intelligence, big data, cloud, and IoT technologies. The development of IT technology and the importance of user experience have provided people with a variety of environments and changed lifestyles. This means that experiences in interactions with people, services(products) and the environment become very important. Therefore, it is time to develop a user needs-based services(products) that can provide new experiences and values to people. This study proposes a chatbot development process based on user needs by applying the design thinking approach, a representative methodology in the field of user experience, to chatbot development. The process proposed in this study consists of four steps. The first step is 'setting up knowledge domain' to set up the chatbot's expertise. Accumulating the information corresponding to the configured domain and deriving the insight is the second step, 'Knowledge accumulation and Insight identification'. The third step is 'Opportunity Development and Prototyping'. It is going to start full-scale development at this stage. Finally, the 'User Feedback' step is to receive feedback from users on the developed prototype. This creates a "user needs-based service (product)" that meets the process's objectives. Beginning with the fact gathering through user observation, Perform the process of abstraction to derive insights and explore opportunities. Next, it is expected to develop a chatbot that meets the user's needs through the process of materializing to structure the desired information and providing the function that fits the user's mental model. In this study, we present the actual construction examples for the domestic cosmetics market to confirm the effectiveness of the proposed process. The reason why it chose the domestic cosmetics market as its case is because it shows strong characteristics of users' experiences, so it can quickly understand responses from users. This study has a theoretical implication in that it proposed a new chatbot development process by incorporating the design thinking methodology into the chatbot development process. This research is different from the existing chatbot development research in that it focuses on user experience, not technology. It also has practical implications in that companies or institutions propose realistic methods that can be applied immediately. In particular, the process proposed in this study can be accessed and utilized by anyone, since 'user needs-based chatbots' can be developed even if they are not experts. This study suggests that further studies are needed because only one field of study was conducted. In addition to the cosmetics market, additional research should be conducted in various fields in which the user experience appears, such as the smart phone and the automotive market. Through this, it will be able to be reborn as a general process necessary for 'development of chatbots centered on user experience, not technology centered'.

Predicting Forest Gross Primary Production Using Machine Learning Algorithms (머신러닝 기법의 산림 총일차생산성 예측 모델 비교)

  • Lee, Bora;Jang, Keunchang;Kim, Eunsook;Kang, Minseok;Chun, Jung-Hwa;Lim, Jong-Hwan
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.1
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    • pp.29-41
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    • 2019
  • Terrestrial Gross Primary Production (GPP) is the largest global carbon flux, and forest ecosystems are important because of the ability to store much more significant amounts of carbon than other terrestrial ecosystems. There have been several attempts to estimate GPP using mechanism-based models. However, mechanism-based models including biological, chemical, and physical processes are limited due to a lack of flexibility in predicting non-stationary ecological processes, which are caused by a local and global change. Instead mechanism-free methods are strongly recommended to estimate nonlinear dynamics that occur in nature like GPP. Therefore, we used the mechanism-free machine learning techniques to estimate the daily GPP. In this study, support vector machine (SVM), random forest (RF) and artificial neural network (ANN) were used and compared with the traditional multiple linear regression model (LM). MODIS products and meteorological parameters from eddy covariance data were employed to train the machine learning and LM models from 2006 to 2013. GPP prediction models were compared with daily GPP from eddy covariance measurement in a deciduous forest in South Korea in 2014 and 2015. Statistical analysis including correlation coefficient (R), root mean square error (RMSE) and mean squared error (MSE) were used to evaluate the performance of models. In general, the models from machine-learning algorithms (R = 0.85 - 0.93, MSE = 1.00 - 2.05, p < 0.001) showed better performance than linear regression model (R = 0.82 - 0.92, MSE = 1.24 - 2.45, p < 0.001). These results provide insight into high predictability and the possibility of expansion through the use of the mechanism-free machine-learning models and remote sensing for predicting non-stationary ecological processes such as seasonal GPP.

Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study

  • Uccella, Stefano;Falcone, Francesca;Greggi, Stefano;Fanfani, Francesco;De Iaco, Pierandrea;Corrado, Giacomo;Ceccaroni, Marcello;Mandato, Vincenzo Dario;Bogliolo, Stefano;Casarin, Jvan;Monterossi, Giorgia;Pinelli, Ciro;Mangili, Giorgia;Cormio, Gennaro;Roviglione, Giovanni;Bergamini, Alice;Pesci, Anna;Frigerio, Luigi;Uccella, Silvia;Vizza, Enrico;Scambia, Giovanni;Ghezzi, Fabio
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.100.1-100.13
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    • 2018
  • Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.

A Study on Containerports Clustering Using Artificial Neural Network(Multilayer Perceptron and Radial Basis Function), Social Network, and Tabu Search Models with Empirical Verification of Clustering Using the Second Stage(Type IV) Cross-Efficiency Matrix Clustering Model (인공신경망모형(다층퍼셉트론, 방사형기저함수), 사회연결망모형, 타부서치모형을 이용한 컨테이너항만의 클러스터링 측정 및 2단계(Type IV) 교차효율성 메트릭스 군집모형을 이용한 실증적 검증에 관한 연구)

  • Park, Ro-Kyung
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.9 no.6
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    • pp.757-772
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    • 2019
  • The purpose of this paper is to measure the clustering change and analyze empirical results, and choose the clustering ports for Busan, Incheon, and Gwangyang ports by using Artificial Neural Network, Social Network, and Tabu Search models on 38 Asian container ports over the period 2007-2016. The models consider number of cranes, depth, birth length, and total area as inputs and container throughput as output. Followings are the main empirical results. First, the variables ranking order which affects the clustering according to artificial neural network are TEU, birth length, depth, total area, and number of cranes. Second, social network analysis shows the same clustering in the benevolent and aggressive models. Third, the efficiency of domestic ports are worsened after clustering using social network analysis and tabu search models. Forth, social network and tabu search models can increase the efficiency by 37% compared to that of the general CCR model. Fifth, according to the social network analysis and tabu search models, 3 Korean ports could be clustered with Asian ports like Busan Port(Kobe, Osaka, Port Klang, Tanjung Pelepas, and Manila), Incheon Port(Shahid Rajaee, and Gwangyang), and Gwangyang Port(Aqaba, Port Sulatan Qaboos, Dammam, Khor Fakkan, and Incheon). Korean seaport authority should introduce port improvement plans by using the methods used in this paper.

A Development and Validation Study of the Web-based Korean Version of the Eating Disorder Diagnostic Scale DSM-5 (웹 기반 한국판 섭식장애진단척도 DSM-5의 개발 및 타당화 연구)

  • Lee, Hye Rin;Kwag, Kyung Hwa;Lee, You Kyung;Han, Soo Wan;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.185-193
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    • 2020
  • Objectives : The aim of this study was to develop and to verify the Korean version of the Eating Disorder Diagnosis Scale DSM-5 (K-EDDS) as a web-based diagnostic system, which enables rapid diagnosis of patients for early intervention. Methods : A total of 119 persons participated in the study, including patients with eating disorders (n=38) and college students (n=81). Along with the paper-and-pencil SCOFF, all participants completed the web-based K-EDDS, the Eating Disorder Examination-Questionaire (EDE-Q), and the Clinical Impairment Assessment Questionnaire (CIA). The semi-structured interview using the Eating Disorder Examination Interview (EDE) was conducted for participants with two or more SCOFF scores. Within two weeks, the web-based K-EDDS, the EDE-Q, and the CIA were re-tested. Results : In the exploratory factor analysis, four factors were extracted : body dissatisfaction, binge behaviors, binge frequency and compensatory behaviors. The four subscales of the web-based K-EDDS had significant correlation with each of the four subscales of the EDE-Q. The internal consistency of the web-based K-EDDS was highly satisfactory (Cronbach's alpha=0.93). The diagnostic agreement between the web-based K-EDDS and the EDE was excellent (96.83%), and the web-based K-EDDS's test-retest diagnostic agreement was fairly good (92.86%). The web-based K-EDDS and the CIA also showed significant differences between patients and general population, supporting discriminant validity. Conclusions : This study suggested that the web-based K-EDDS is a valid tool for assisting diagnosis of eating disorders based on DSM-5 in clinical and research fields.

Plasma Levels of Cytokines in Patients with Postpartum Depression (산후우울증 환자에서 혈장 Cytokine의 농도변화에 대한 전향적 연구)

  • Lee, Younjung;Kim, Yong-Ku;Kim, Kye-Hyun;Lee, Bun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.177-184
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    • 2020
  • Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.