• Journal of Korean Society for Quality Management
• /
• v.51 no.4
• /
• pp.531-550
• /
• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.156-162
• /
• 2024

Background: This study aimed to explore the relationship between frailty and Area Deprivation Index (ADI) among older adults in Korea. Methods: We used data from the Korea National Health and Nutrition Examination Survey from 2014 to 2019, focusing on individuals aged 65 years and older. Frailty was assessed using Fried phenotype of frailty criteria. A multiple logistic regression analysis was conducted to assess the relationship between frailty and ADI adjusted for all covariates. Results: Among 9,825 older adults, those who lived in an area with a high ADI had a 1.2-fold higher risk of frailty compared to those who lived in an area with a low ADI (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.09-1.37). Particularly, married individuals living in areas with a high ADI had an approximately 1.4-fold higher risk of frailty compared to those living in areas with a low ADI (OR, 1.35; 95% CI, 1.16-1.57). Conclusion: This study reveal a significant relationship between frailty and the ADI among older adults. In particular, married individuals who live in areas with a high ADI were found more vulnerable to frailty than those who live in areas with a low ADI. Therefore, policy intervention should be implemented to reduce health inequalities among older people, especially those living in the most deprived areas groups.

• Korean Journal of Soil Science and Fertilizer
• /
• v.19 no.4
• /
• pp.283-289
• /
• 1986

To establish a suitability grouping system of paddy soils for multiple cropping of rice with other upland crops, the study was carried out after a few basic experiments. In succession to the results on basic experiment prior, the suitability system proposed and the results of application mentioned in this report were summarized as follows; 1. The factors of soil properties in the system were productivities represented by soil texture and drainage class, as well as salinity of surface and sub-soil pH of chemical properties were considered together with slope, warmth index, ground water table, parent materials etc. of soil physical or environmental conditions. The weights of the factors were combined with multiplicatively and additively so as the total marks of ideal soil to be 100. The system was composed with 5 suitability classes; over 91 mark is class I, under 60 mark class V, and each 10 point interval between classes. The limiting factors "P" (in the case that Physical properties or Productivity marks under 24), "S" (Surface slope less than 15) and "C" (Chemical condition below 15) etc. were appended up to two kinds to the classes except a part of soils in class I. 2. The areas where the warmth index exceed 110 in Yeongnam were 19% for class I, 22.7% for class II, 44.7% for class III, 11.5% for class IV, and 2.1% for class V. The rates in class I and II were slightly more than those of the whole country. 3. The points of each soil gained by the system had a positive correlation ($r=.922^{**}$) with the potential productivities.

• Journal of Internet Computing and Services
• /
• v.15 no.3
• /
• pp.101-107
• /
• 2014

With the development of online service, recent forms of databases have been changed from static database structures to dynamic stream database structures. Previous data mining techniques have been used as tools of decision making such as establishment of marketing strategies and DNA analyses. However, the capability to analyze real-time data more quickly is necessary in the recent interesting areas such as sensor network, robotics, and artificial intelligence. Landmark window-based frequent pattern mining, one of the stream mining approaches, performs mining operations with respect to parts of databases or each transaction of them, instead of all the data. In this paper, we analyze and evaluate the techniques of the well-known landmark window-based frequent pattern mining algorithms, called Lossy counting and hMiner. When Lossy counting mines frequent patterns from a set of new transactions, it performs union operations between the previous and current mining results. hMiner, which is a state-of-the-art algorithm based on the landmark window model, conducts mining operations whenever a new transaction occurs. Since hMiner extracts frequent patterns as soon as a new transaction is entered, we can obtain the latest mining results reflecting real-time information. For this reason, such algorithms are also called online mining approaches. We evaluate and compare the performance of the primitive algorithm, Lossy counting and the latest one, hMiner. As the criteria of our performance analysis, we first consider algorithms' total runtime and average processing time per transaction. In addition, to compare the efficiency of storage structures between them, their maximum memory usage is also evaluated. Lastly, we show how stably the two algorithms conduct their mining works with respect to the databases that feature gradually increasing items. With respect to the evaluation results of mining time and transaction processing, hMiner has higher speed than that of Lossy counting. Since hMiner stores candidate frequent patterns in a hash method, it can directly access candidate frequent patterns. Meanwhile, Lossy counting stores them in a lattice manner; thus, it has to search for multiple nodes in order to access the candidate frequent patterns. On the other hand, hMiner shows worse performance than that of Lossy counting in terms of maximum memory usage. hMiner should have all of the information for candidate frequent patterns to store them to hash's buckets, while Lossy counting stores them, reducing their information by using the lattice method. Since the storage of Lossy counting can share items concurrently included in multiple patterns, its memory usage is more efficient than that of hMiner. However, hMiner presents better efficiency than that of Lossy counting with respect to scalability evaluation due to the following reasons. If the number of items is increased, shared items are decreased in contrast; thereby, Lossy counting's memory efficiency is weakened. Furthermore, if the number of transactions becomes higher, its pruning effect becomes worse. From the experimental results, we can determine that the landmark window-based frequent pattern mining algorithms are suitable for real-time systems although they require a significant amount of memory. Hence, we need to improve their data structures more efficiently in order to utilize them additionally in resource-constrained environments such as WSN(Wireless sensor network).

• Journal of Intelligence and Information Systems
• /
• v.23 no.2
• /
• pp.1-17
• /
• 2017

The deep learning framework is software designed to help develop deep learning models. Some of its important functions include "automatic differentiation" and "utilization of GPU". The list of popular deep learning framework includes Caffe (BVLC) and Theano (University of Montreal). And recently, Microsoft's deep learning framework, Microsoft Cognitive Toolkit, was released as open-source license, following Google's Tensorflow a year earlier. The early deep learning frameworks have been developed mainly for research at universities. Beginning with the inception of Tensorflow, however, it seems that companies such as Microsoft and Facebook have started to join the competition of framework development. Given the trend, Google and other companies are expected to continue investing in the deep learning framework to bring forward the initiative in the artificial intelligence business. From this point of view, we think it is a good time to compare some of deep learning frameworks. So we compare three deep learning frameworks which can be used as a Python library. Those are Google's Tensorflow, Microsoft's CNTK, and Theano which is sort of a predecessor of the preceding two. The most common and important function of deep learning frameworks is the ability to perform automatic differentiation. Basically all the mathematical expressions of deep learning models can be represented as computational graphs, which consist of nodes and edges. Partial derivatives on each edge of a computational graph can then be obtained. With the partial derivatives, we can let software compute differentiation of any node with respect to any variable by utilizing chain rule of Calculus. First of all, the convenience of coding is in the order of CNTK, Tensorflow, and Theano. The criterion is simply based on the lengths of the codes and the learning curve and the ease of coding are not the main concern. According to the criteria, Theano was the most difficult to implement with, and CNTK and Tensorflow were somewhat easier. With Tensorflow, we need to define weight variables and biases explicitly. The reason that CNTK and Tensorflow are easier to implement with is that those frameworks provide us with more abstraction than Theano. We, however, need to mention that low-level coding is not always bad. It gives us flexibility of coding. With the low-level coding such as in Theano, we can implement and test any new deep learning models or any new search methods that we can think of. The assessment of the execution speed of each framework is that there is not meaningful difference. According to the experiment, execution speeds of Theano and Tensorflow are very similar, although the experiment was limited to a CNN model. In the case of CNTK, the experimental environment was not maintained as the same. The code written in CNTK has to be run in PC environment without GPU where codes execute as much as 50 times slower than with GPU. But we concluded that the difference of execution speed was within the range of variation caused by the different hardware setup. In this study, we compared three types of deep learning framework: Theano, Tensorflow, and CNTK. According to Wikipedia, there are 12 available deep learning frameworks. And 15 different attributes differentiate each framework. Some of the important attributes would include interface language (Python, C ++, Java, etc.) and the availability of libraries on various deep learning models such as CNN, RNN, DBN, and etc. And if a user implements a large scale deep learning model, it will also be important to support multiple GPU or multiple servers. Also, if you are learning the deep learning model, it would also be important if there are enough examples and references.

• Tuberculosis and Respiratory Diseases
• /
• v.54 no.3
• /
• pp.283-294
• /
• 2003

Introduction : Rapidly growing nontuberculous mycobacteria (RGM) can produce numerous types of manifestations including a pulmonary infection. Managing a pulmonary infection due to RGM is unusually difficult to treat because the organism is invariably resistant to traditional antituberculous drugs and has a varying susceptibility to other antibiotics. The experiences of treatments for a RGM pulmonary infection with various antibiotics are also limited. This study evaluated the clinical manifestations, treatment, and the therapeutic outcomes of a RGM pulmonary infection. Subjects and method : Fifty-four cases with RGM from respiratory specimens were identified between November of 1996 and September of 2002 in the Asan medical center. The medical records and radiographic findings in 20 patients who fulfilled the diagnostic criteria of nontuberculous mycobacteria (NTM) pulmonary disease by ATS guidelines. The clinical, laboratory, and radiological parameters between subgroups. Results : Of the 20 patients, 15 were female. The mean age was 57.7 yrs (${\pm}7.5$), and all of the patients had a history of pulmonary tuberculosis. Most (90%) had an underlying lung disease. The majority of the isolates (80%) were M. abscessus. Chest radiography showed bilateral involvement in 80% of the patients. Bronchiectasis and multiple nodules were the main findings. Cavitation was present in 35% of the patients. Even though 70 % of the patients received antituberculous drugs prior to the correct diagnosis, all of the patients eventually received antibiotics. A mean of 3.5 antibiotics were given for an average of 439 days(${\pm}168$). After completing treatment, nine patients showed improvement after a mean 591(${\pm}311$) days of treatment, whereas the antibiotic treatment was unsuccessful in 2 patients. Conclusion : Many patients with a RGM pulmonary infection show an atypical pattern of radiological findings (bronchiectasis and multiple centrilobular nodules). It is very important to differentiate between M. tuberculosis and NTM and to identify the causative organisms among the NTM because a misdiagnosis can lead to an inappropriate and prolonged treatment. Combined antibiotic treatment yielded promising results, and is recommended for treating patients with a RGM pulmonary infection.

• Journal of the Korean Society of Food Culture
• /
• v.9 no.4
• /
• pp.379-394
• /
• 1994

The purpose of this study was to identify the correlation between the factors influencing on housewives' decision-making processes of organic foods and the relating variables, and the 5 stages of decision-making processes of the EBK model is utilized in this study. The sample was selected from 411 housewives living in Seoul from 1st of September through 20th of September, 1993. Frequency, Percentage, Mean, Factor analysis, One-way ANOVA, Duncan's multiple range test, t-Test, Correlation, Multiple regression analysis and Path analysis were measured. Major results are as follows: 1. Purchasing motivation of the organic foods were in order of the health care, nutritive value and taste care. 2. The major informations source for the knowledge of organic foods were in order of TV/radio, newspaper/magazine, recommendations informations and advice through a family/friends/acquaintances. 3. Evalution criteria in shopping of organic foods, the total degree of consideration over the purchasing factors of organic foods was fairly high level: consumers thought much of the sanitation/freshness, nutritive value and the food safety. In this regard opinion leaders was dominantly mass media. Consumers have a tendency to purchase organic foods in consideration of their children and husband. 4. Major place to purchase organic foods are super markets and department stores. And When shopping organic foods, housewives by all means confirm the check points in their own mind, which were expiry date, manufactured date and packing condition, but unexpectedly manufactured company was out of concern. 5. Housewives usually satisfy with decision after purchasing organic foods, while they were fairly unsatisfied with the price, quality, incomplete description for ingredients and manufactured date. 6. The variables influencing to the sincerity when selecting the most desired organic foods is how be cares about the natural freshness of the foods and the types of residents in order. Another interesting tendency is the richer they are very considerate to decide. It is to say the people who cares more about the natural freshness is the sincerer when making decision and also the class who lives in the apartment house enjoying high income do not easily accept the product quality.

• Journal of Trauma and Injury
• /
• v.20 no.2
• /
• pp.57-64
• /
• 2007

Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.4
• /
• pp.487-496
• /
• 2021

Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

• Korean Journal of Psychosomatic Medicine
• /
• v.27 no.1
• /
• pp.35-41
• /
• 2019

Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.