• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.38-44
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• 2018

Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

• International Journal of Advanced Culture Technology
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• v.7 no.2
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• Translational and Clinical Pharmacology
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• v.26 no.3
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• pp.128-133
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• 2018

Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

• Journal of Digital Forensics
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• v.12 no.3
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• pp.83-96
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• 2018

Electronic medical records in the hospital information system are the important evidence related to the crime and are subject to search and seizure. In the case of a large general hospital, it is possible to search for seizures through cooperation of the staff, but it is impossible in small hospitals. The investigation agency copies the database of electronic medical records and then selects relevant content. This approach has an issue of excessive search and seizure. In this paper, we propose field selection procedures and methods for electronic medical records while ensuring integrity, reproducibility, and chain of custody. Currently, it is necessary to study the procedures and methods of search and seizure of medical information system so that it can respond to next changing cloud hospital information system.

• Journal of Digital Convergence
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• v.17 no.8
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• pp.321-327
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• 2019

The purpose of this research is to identify the level of perception of conflict with politics within nursing organizations in large general hospitals, and to empirically analyze how politics and conflicts in the organization affect workplace bullying(taeoom) within nursing organizations. The research method conducted multiple regression analysis on 273 nurses working at A University Hospital in Seoul. The analysis shows that political and relationship conflicts within the organization are amplifying the workplace bullying within the nursing system. It was confirmed that taeoom was also increasing as conflicts between factions or subgroups within the nursing system, alienation, and emotional conflicts among members grew. We hope that the future research regarding taeoom will seek serious theoretical insights and practical implications for its management.

• Quality Improvement in Health Care
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• v.24 no.2
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• pp.62-75
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• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• International Journal of Computer Science & Network Security
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• v.21 no.2
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• pp.171-180
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• 2021

Currently, hospitals and medical practices have a large amount of unstructured information, gathered in time at each ward or practice by physicians in a wide range of medical branches. The data requires processing in order to be able to extract relevant information, which can be used to improve the medical system. It is useful for a physician to have access to a patient's entire medical history when he or she is in an emergency situation, as relevant information can be found about the patient's problems such as: allergies to various medications, personal history, or hereditary collateral conditions etc. If the information exists in a structured form, the detection of diseases based on specific symptoms is much easier, faster and with a higher degree of accuracy. Thus, physicians may investigate certain pathological profiles and conduct cohort clinical trials, including comparing the profile of a particular patient with other similar profiles that already have a confirmed diagnosis. Involving information technology in this field will change so the time which the physicians should spend in front of the computer into a much more beneficial one, providing them with the possibility for more interaction with the patient while listening to the patient's needs. The expert system, described in the paper, is an application for medical diagnostic of the most frequently met conditions, based on logical programming and on the theory of probabilities. The system rationale is a search item in the field basic knowledge on the condition. The web application described in the paper is implemented for the ward of pathological anatomy of a hospital in Romania. It aims to ease the healthcare staff's work, to create a connection of communication at one click between the necessary wards and to reduce the time lost with bureaucratic proceedings. The software (made in PHP programming language, by writing directly in the source code) is developed in order to ease the healthcare staff's activity, being created in a simpler and as elegant way as possible.

• Progress in Medical Physics
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• v.31 no.4
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• pp.194-204
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• 2020

This study investigated and analyzed the Korean and international status of radioactive waste management for medical linear accelerators (linacs) and proceed prior research to suggest radiation safety regulations and guidelines for the safe use of radiation. We analyzed the number of linacs installed in the radiation oncology departments of 103 institutions. In addition, we analyzed the procedures and standards for disposal in Korea and foreign countries. For foreign countries, we analyzed the status based on reports from the United States, Japan, Europe, and Canada. A total of 182 linacs are installed in Korea and 95% of them use more than 10 MV of energy. In Korea, standards for managing radioactive waste from a linac, disposal procedures, and clearance criteria have yet to be established. Therefore, radioactive waste is disposed of in different ways depending on the hospitals where they originate. Japan, the US, and Canada have recommended clearance levels and procedures for linacs. Other countries have provided management guidelines for research or large-scale accelerators, but not for medical purposes. In this study, we investigated the management of radioactive waste from medical linacs in Korea and abroad. Several foreign countries have suggested a clearance level and criteria for disposing of waste storage drums. For the safe management of medical linacs, it is necessary to establish safety management regulations. In Korea, standards for disposal, such as radiation or dose limits, are required for medical linacs. A system for clearance when disposing at a medical institution should be created.

• Knowledge Management Research
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• v.22 no.1
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• pp.1-19
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• 2021

Large-scaled hospital information system projects are often delayed than originally planned. Regarding project management, it is necessary to examine main factors triggering the schedule delay and to analyze the causality of such delay. This study tries to find the delay factors and causal relationship between them based on the case of the hospital information system development project by using the grounded theory method. It turned out that 'unrealistic scheduling' affects overall schedule delays like domino phenomenon, and 'poor analysis of existing systems' leads to poor quality of work analysis while 'poor subsystem integrated interface' triggers poor design quality. This study found out the factors affecting the delay of a project, analyzing cause-and-effect relationships between them in the academic side. From the practical view, it shows a solution to minimize delays in the project schedule for each of SI companies, hospitals and project managers.

• Design & Manufacturing
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• v.15 no.1
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• pp.26-31
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• 2021

As the aging ages, the disease also increases, and the development of AI technology and X-ray equipment used to treat patients' diseases is also progressing a lot. X-ray tube converts only 1% of electron energy into X-ray and 99% into thermal energy. Therefore, when the cooling time of the anode and the X-ray tube are frequently used in large hospitals, the amount of X-ray emission increases due to temperature rise, the image quality deteriorates due to the difference in X-ray dose, and the lifespan of the overheated X-ray tube may be shortened. Therefore, in this study, temperature rise and cooling time of 60kW, 75kW, and 90kW of X-ray tube anode input power were studied. In the X-ray Tube One shot 0.1s, the section where the temperature rises fastest is 0.03s from 0s, and it is judged that the temperature has risen by more than 50%. The section in which the temperature drop changes most rapidly at 20 seconds of cooling time for the X-ray tube is 0.1 seconds to 0.2 seconds, and it is judged that a high temperature drop of about 65% or more has occurred. After 20 seconds of cooling time from 0 seconds to 0.1 seconds of the X-ray tube, the temperature is expected to rise by more than 3.7% from the beginning. In particular, since 90kW can be damaged by thermal shock at high temperatures, it is necessary to increase the surface area of the anode or to require an efficient cooling system.