Hong Ju Shin;Wan Kee Kim;Jin Kyoung Kim;Joon Bum Kim;Sung-Ho Jung;Suk Jung Choo;Cheol Hyun Chung;Jae Won Lee
Korean Circulation Journal
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v.52
no.2
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pp.136-146
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2022
Background and Objectives: There still are controversies on which type between bovine pericardial and porcine valves is superior in the setting of aortic valve replacement (AVR). This study aims to compare clinical outcomes of AVR using between pericardial or porcine valves. Methods: The study involved consecutive 636 patients underwent isolated AVR using stented bioprosthetic valves between January 2000 and May 2016. Of these, pericardial and porcine valves were implanted in 410 (pericardial group) and 226 patients (porcine group), respectively. Clinical outcomes including survival, structural valve deterioration (SVD) and trans-valvular pressure gradient were compared between the groups. To adjust for potential selection bias, inverse probability treatment weighting (IPTW) was conducted. Results: The mean follow-up duration was 60.1±50.2 months. There were no significant differences in the rates of early mortality (3.1% vs. 3.1%; p=0.81) and SVD (0.3%/patient-year [PY] vs. 0.5%/PY; p=0.33) between groups. After adjustment using IPTW, however, landmark mortality analyses showed a significantly lower late (>8 years) mortality risk in pericardial group over porcine group (hazard ratio [HR], 0.61; 95% confidence interval, [CI] 0.41-0.90; p=0.01) while the risks of SVD were not significantly difference between groups (HR, 0.45; 95% CI, 0.12-1.70; p=0.24). Mean pressure gradient across prosthetic AV was lower in the Pericardial group than the Porcine group at both immediate postoperative point and latest follow-up (p values <0.001). Conclusions: In patients undergoing bioprosthetic surgical AVR, bovine pericardial valves showed superior results in terms of postoperative hemodynamic profiles and late survival rates over porcine valves.
Kim, Gungyu;Kwag, Shinyoung;Eem, Seunghyun;Jin, Seung-Seop
KSCE Journal of Civil and Environmental Engineering Research
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v.44
no.3
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pp.277-282
/
2024
Recently, the intensity and frequency of typhoons have been increasing due to climate change, and typhoons can cause a loss of offsite power (LOOP) at nuclear power plants (NPPs). Therefore, it is necessary to prepare for typhoon-induced high winds through the probabilistic safety assessment (PSA) of offsite power systems. However, research on PSA for offsite power system in NPPs under typhoon-induced high winds is still lacking. In this study, PSA was performed for offsite power systems subjected to typhoon-induced high winds at the Kori NPP site, which has experienced frequent damages to its offsite power system among NPP sites in Korea. In order to perform PSA for typhoon-induced high winds in offsite power systems, the typhoon hazard at Kori NPP site was derived using logic tree and Monte Carlo simulation. Utilizing the fragility of components constituting the power system, performed a fragility analysis of the power system. Lastly, the probability that offsite power system will not be able to supply power to the NPP was derived.
Min-A Shin;Seok Oh;Min Chul Kim;Doo Sun Sim;Young Joon Hong;Ju Han Kim;Youngkeun Ahn;Myung Ho Jeong
The Korean journal of internal medicine
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v.39
no.1
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pp.110-122
/
2024
Background/Aims: Due to limited real-world evidence on the association between time to presentation (T2P) and outcomes following acute myocardial infarction and diabetes (AMI-DM), we investigated the characteristics of patients with AMI-DM and their outcomes based on their T2P. Methods: 4,455 patients with AMI-DM from a Korean nationwide observational cohort (2011-2015) were divided into early and late presenters according to symptom-to-door time. The effects of T2P on three-year all-cause mortality were estimated using inverse probability of treatment weighting (IPTW) and survival analysis. Results: The incidence of all-cause mortality was consistently higher in late presenters than in early presenters (11.4 vs. 17.2%; p < 0.001). In the IPTW-adjusted dataset, the incidence of all-cause mortality was numerically higher in late presenters than in early presenters (9.1 vs. 12.4%; p = 0.072). In the survival analysis, the cumulative incidence of all-cause mortality was significantly higher in late presenters than in early presenters before and after IPTW. In the subgroup with ST-elevation myocardial infarction, late presenters had a higher incidence of cardiac death than early presenters before (4.8 vs. 10.5%; p < 0.001) and after IPTW (4.2 vs. 9.7%; p = 0.034). In the initial glycated hemoglobin (HbA1c)-stratified analysis, these effects were attenuated in patients with HbA1c ≥ 9.0% before (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 0.80-2.64) and after IPTW (adjusted HR: 0.82, 95% CI: 0.40-1.67). Conclusions: Late presentation was associated with higher mortality in patients with AMI-DM; therefore, multifaceted and systematic interventions are needed to decrease pre-hospital delays.
Kim, Sang-Gon;Jeong, Jae-Kwan;Hur, Tae-Young;Kang, Hyun-Gu;Kim, Ill-Hwa
Journal of Veterinary Clinics
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v.30
no.3
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pp.178-185
/
2013
This study evaluated the effects of milk yield on the postpartum health and reproductive performance of dairy cows. In total, data were collected from 1,060 cows on six dairy farms, including their milk production, body condition score (BCS), postpartum disorders, and reproductive performance. The lactation data were grouped based on the 305-day milk yield into control (< 10,000 kg, n = 445) and high milk yield (${\geq}$ 10,000 kg, n = 615) groups. The milk fat and protein, and BCS were lower during the first 5 months postpartum in the high milk yield group compared with the control group (p < 0.01). Ovarian cysts were more frequent (p < 0.0001) in the high milk yield group (28.6%) than in the control group (15.3%), whereas endometritis tended to be less frequent in the high milk yield group (29.6%) than in the control group (35.1%, p = 0.06). A higher proportion of cows tended to receive reproductive hormones (p = 0.06) in the high milk yield group (62.4%) than in the control group (56.6%). The probability of a pregnancy after first insemination tended to be lower (odds ratio = 0.78, p = 0.07) in the high milk yield group (30.2%) than in the control group (35.2%). Furthermore, the hazard of pregnancy by 210 days in milk was lower in the high milk yield group (hazard ratio = 0.84, p = 0.04) than in the control group, which resulted in a 20-day increase in the median interval to pregnancy. In conclusion, high milk yield was related to lower milk fat and protein, lower BCS, an increased incidence of ovarian cysts, and increased use of reproductive hormones, which resulted in decreased reproductive performance of dairy cows.
Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.
The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.
This study examines the hazard rate of reemployment by conducting the Cox regression analysis. In addition, two gender groups are subjected to comparative analysis to identify the effect of the factors related to the human capital and human capability perspective on reemployment. For this purpose, 1,871 cases are selected from the 5th year data from Korea Labor and Income Panel Study. The results of study are as follows. First, the factors of human capital, such as education, appropriateness of skill level, and job tenure hold negative impact on the probability of reemployment, while factors of human capability, such as basic learning ability, health insurance, social insurance, residential area(living in the Seoul metropolitan area) hold positive on the probability of reemployment. It is interesting note that there are different sets of factors that affect the probability of reemployment in the two gender groups. This trend is even more apparent in the case of factors that pertain to human capability. The results of this study imply that the factors of human capability, which stress the socio-institutional characteristics, should be considered as comparably significant compared to the factors that pertain to human capital when it comes to the estimation of reemployment. Also, results of this comparative study teach us that various perspectives, such as dual labor market theory and gender-segmented labor market theory, should be factored in for reemployment discussion as well. In conclusion, this research delivers several significant messages since it introduces the concept of human capability perspective, subjected to few empirical analyses in the past, and also heralds the way for comparative analysis on the impact of the factors pertaining to human capability on reemployment.
For the purpose of the study, of the 76 areas subject to preliminary concentrated management on sediment disaster in the downtown area, 9 areas were selected as research areas. They were classified into three stratified rock areas (Gyeongsan City, Goheung-gun and Daegu Metropolitan City), three igneous rock areas (Daejeon City, Sejong Special Self-Governing City and Wonju City) and three metamorphic rock areas (Namyangju City, Uiwang City and Inje District) according to the characteristics of the bedrock in the research areas. As for the 9 areas, analyses were conducted based on tests required to calculate soil characteristics, a predictive model for root adhesive power, loading of trees and on-the-spot research. As for a rainfall scenario (rainfall intensity), the probability of rainfall was applied as offered by APEC Climate Center (APCC) in Busan. As for the prediction of landslide risks in the 9 areas, TRIGRS and LSMAP were applied. As a result of TRIGRIS prediction, the risk rate was recorded 30.45% in stratified rock areas, 41.03% in igneous rock areas and 45.04% in metamorphic rock areas on average. As a result of LSMAP prediction based on root cohesion and the weight of trees according to crown density, it turned out to a 1.34% risk rate in the stratified rock areas, 2.76% in the igneous rock areas and 1.64% in the metamorphic rock areas. Analysis through LSMAP was considered to be relatively local predictive rather than analysis using TRIGRS.
Through lessons in recent earthquakes, the bridge engineering community recognizes the need for new seismic design methodologies based on the inelastic structural performance of RC bridge structures. This study represents results of performance-based fragility analysis of reinforced concrete (RC) bridge. Monte carlo simulation is performed to study nonlinear dynamic responses of RC bridge. Two-parameter log-normal distribution function is used to represent the fragility curves. These two-parameters, referred to as fragility parameters, are estimated by the traditional maximum likelihood procedure, which is treated each event of RC bridge pier damage as a realization of Bernoulli experiment. In order to formulate the fragility curves, five different damage states are described by two practical factors: the displacement and curvature ductility, which are mostly influencing on the seismic behavior of RC bridge piers. Five damage states are quantitatively assessed in terms of these seismic ductilities on the basis of numerous experimental results of RC bridge piers. Thereby, the performance-based fragility curves of RC bridge pier are provided in this paper. This approach can be used in constructing the fragility curves of various bridge structures and be applied to construct the seismic hazard map.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.8
/
pp.342-347
/
2020
Recently, as the collaborative robot has been introduced into the domestic industrial robot market, it is installed mainly in the manufacturing industry. Collaborative robots are subject to the safety regulations of industrial robots by Article 93 of the Safety Inspection of the Industrial Safety and Health Act. The sites where collaborative robots are to be installed must perform risk assessments for robots-humans, work environments, and work methods and reduce the risks according to ISO 10218-2 and ISO 12100. On the other hand, because it is early in the introduction of collaborative robots, new risks for collaborative robots have not been issued, and risk assessments are unfamiliar and difficult to apply in the workplace. The risk assessment of collaborative robots aims to identify and reduce the risk of a high probability of occurrence by focusing on the abnormal behavior of humans, human errors, equipment defects, and interlock functions. In this study, a risk assessment was applied to a domestic automobile parts production plant, and improvement measures were drawn. This risk assessment is expected to be useful for improving the safety of small businesses by continuously discovering risk assessment examples of collaborative robots.
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