• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.4 no.1
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• pp.40-49
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• 1999

A laboratory flume experiment, using turbulence-generating acryl tank and natural sediments, was conducted to investigate the effects of salinity, concentration of suspended sediment, turbulence and clay minerals on the flocculation and settling of fine-grained suspended sediments. While experiments were run, a sequence of water samples were taken near the bottom of the tank to analyze the variations of size distribution and relative contents of clay minerals. The results of the salinity experiment indicate that median settling velocity ($W_{50}$) increases linearly with salinity. Different settling processes of suspended sediments under variable concentrations appear to be predictable, depending upon the range of the suspension concentration. At concentrations less than 200 mg/l, $W_{50}$ is rarely varied with concentration probably because of the individual--grain settling mode. In the range of 200 to 13,000 mg/l show $W_{50}$ and concentration a good relationship following an empirical formula: $W_{50}=0.45C^{0.44}$. This relationship, however, no longer holds in concentrations exceeding 13,000 mg/l; instead, a more or less reverse one is shown. This result suggests an effect of hindered settling. The turbulence effect is somewhat different from that of concentration. Turbulence accelerates the flocculation and settling susepended sediments at low concentration (200 mg/l), whereas at high concentration turbulence breaks floes down and impedes the settling. Size distribution of suspended sediments sampled near the bottom of the tank tend to be more negatively skewed and leptokurtic in turbulent conditions compared to those in static conditions. The clay mineral analysis from the sequential water samples shows that over time the content of smectite decreases most rapidly with illite remaining concentrated in suspension. This means that smectite, among other clay minerals, plays the most effective role in the flocculation of fine-grained sediment in saline water.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.13-18
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• 2004

This study was designed to establish working range for reoportable range in own laboratory in order to cover the upper and lower limits of the range in test method. We experimented ten times during 10 days for setting of reportable range with between run for method evaluation. It is generally assumed that the analytical method produces a linear response and that the test results between those upper and lower limits are then reportable. CLIA recommends that laboratories verify the reportable range of all moderate and high complexity tests. The Clinical Laboratory Improvement Amendments(CLIA) and Laboratory Accreditation Program of the Korean Society for Laboratory Medicine states reportable range is only required for "modified" moderately complex tests. Linearity requirements have been eliminated from the CLIA regulations and from others accreditation agencies, many inspectors continue to feel that linearity studies are a part of good lab practice and should be encouraged. It is important to assess the useful reportable range of a laboratory method, i.e., the lowest and highest test results that are reliable and can be reported. Manufacturers make claims for the reportable range of their methods by stating the upper and lower limits of the range. Instrument manufacturers state an operating range and a reportable range. The commercial linearity material can be used to verify this range, if it adequately covers the stated linear interval. CLIA requirements for quality control, must demonstrate that, prior to reporting patient test results, it can obtain the performance specifications for accuracy, precision, and reportable range of patient test results, comparable to those established by the manufacturer. If applicable, the laboratory must also verify the reportable range of patient test results. The reportable range of patient test results is the range of test result values over which the laboratory can establish or verify the accuracy of the instrument, kit or test system measurement response. We need to define the usable reportable range of the method so that the experiments can be properly planned and valid data can be collected. The reportable range is usually defined as the range where the analytical response of the method is linear with respect to the concentration of the analyte being measured. In conclusion, experimental results on reportable range using concentrated control sample and zero calibrators covering from highest to lowest range were salicylate $8.8{\mu}g/dL$, phenytoin $0.67{\mu}g/dL$, phenobarbital $1.53{\mu}g/dL$, primidone $0.16{\mu}g/dL$, theophylline $0.2{\mu}g/dL$, vancomycine $1.3{\mu}g/dL$, valproic acid $3.2{\mu}g/dL$, digitoxin 0.17ng/dL, carbamazepine $0.36{\mu}g/dL$ and acetaminophen $0.7{\mu}g/dL$ at minimum level and salicylate $969.9{\mu}g/dL$, phenytoin $38.1{\mu}g/dL$, phenobarbital $60.4{\mu}g/dL$, primidone $24.57{\mu}g/dL$, theophylline $39.2{\mu}g/dL$, vancomycine $83.65{\mu}g/dL$, valproic acid $147.96{\mu}g/dL$, digitoxin 5.04ng/dL, carbamazepine $19.76{\mu}g/dL$, acetaminophen $300.92{\mu}g/dL$ at maximum level.

• Journal of Life Science
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• v.22 no.11
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• pp.1456-1462
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• 2012

Sorafenib is a multikinase inhibitor and an oral anticancer drug approved for the treatment of patients with advanced renal cell carcinoma and those with unresectable hepatocellular carcinoma. The purpose of this study was to develop an efficient method of the determination of sorafenib in human plasma using tandem mass spectrometry coupled with liquid chromatography (LC/MS/MS) and validate the method by the guidelines of the Korean Food and Drug Administration (KFDA). Plasma samples ($100{\mu}l$) were added with chlorantraniliprole as an internal standard and then mixed with the 0.1% formic acid-containing extraction solution composed of isopropyl alcohol and ethyl acetate (1:4, v/v). After centrifugation, the supernatant was concentrated at $45^{\circ}C$ under negative pressure and centrifugal force. The residue was reconstituted with a mobile phase and injected into the HPLC instrument using a reverse phase Waters XTerra$^{TM}$ C18 column (particle size $3.5{\mu}m$). Liquid chromatography was carried out within the run time of 5 min using a mobile phase composed of buffer (0.1% formic acid and 10 mM ammonium formate), methanol, and acetonitrile (1:6:3, v/v/v). The analytes were monitored by tandem mass spectrometry in the multiple reaction monitoring method programmed to detect sorafenib at 'm/z 465.2 ${\rightarrow}$ 252.5' and chlorantraniliprole at 'm/z 484.4 ${\rightarrow}$ 286.2' with positive electrospray ionization mode ($ES^+$). The result showed the proper linearity ($r^2$ > 0.99) over the range of 2,000-5,000 ng/ml with good accuracy (90.7-103.9%) and precision (less than 10%). The newly developed method using LC/MS/MS was validated by the guideline of KFDA and identified as more sensitive compared to the previous methods.

• Convergence Security Journal
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• v.11 no.2
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• pp.13-24
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• 2011

Policemen judge the situations rationally and use their equipment such as handcuffs and rope within the purview, finding them needed to arrest criminals in the act who commit crimes which conforms to death penalty, life imprisonment or long imprisonment for over 3 years in accordance with Clause 10-2, Article 1 of the Police Mandate Law and prevent fleeing from them, defend their and others' lives and bodies, or if there are probable causes to be recognized that using equipment is necessary to restrain the interference with government officials in the execution of their duties. However, as the cases which the criminals run away in handcuffs or with both hands tied occur, it results in the waste of police force, distrust and enormous trouble in the pursuit of their duties. Therefore, if the way to perceive fleeing of criminals who have already worn the police equipment by some simple assistive devices without developing other new equipment, it will be very effective for police duties. This study is about the combination apparatus for fugitive prevention attached to the existing handcuffs and rope whose alert sounds let the staffs working inside the office perceive the fleeing of wanted criminals and examined suspects who wear the handcuffs or are tied up with rope, providing that they go through the exit where a transmitter and a receiver were set. The combination apparatus for fugitive prevention which the study introduces contains the connecting parts which connect a flexible tube(cognition tags inside of the tube) of connector equipped with the police equipment with the ends of the tube and the part where these two meet and which connect them inside of the tube. The connecting parts are easy to be attached to the police equipment such as handcuffs and rope, but hard to be dismantled by the people tied up with the equipment. It enables watchers to perceive the fleeing of wanted criminals and examined suspects who wear the handcuffs or are tied up with rope, providing that they go through the exit where a transmitter and a receiver were set. Plus, if it is combined together with the portable receiver, it can be installed on the patrol cars and easily adopted to supervise illegally accessing of evidences. It is also avaliable to be adjunctively utilized for the handcuffs provided and the cost is so reasonable. Owing to its snap-on way to the cuffs, it can clear up any invasion of privacy and it can not be used as a self-injury tool because of the soft tube. Using AM Tag minimizes the lack of malfunction.

• KEPCO Journal on Electric Power and Energy
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• v.5 no.3
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• pp.209-213
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• 2019

Recently, demand for high energy density and long cycling stability of energy storage system has increased for application using with frequency regulation (F/R) in power grid. Supercapacitor have long lifetime and high charge and discharge rate, it is very adaptable to apply a frequency regulation in power grid. Supercapacitor can complement batteries to reduce the size and installation of batteries. Because their utilization in a system can potentially eliminate the need for short-term frequent replacement as required by batteries, hence, saving the resources invested in the upkeep of the whole system or extension of lifecycle of batteries in the long run of power grid. However, low energy density in supercapacitor is critical weakness to utilization for huge energy storage system of power grid. So, it is still far from being able to replace batteries and struggle in meeting the demand for a high energy density. But, today, LIC (Lithium Ion Capacitor) considered as an attractive structure to improve energy density much more than EDLC (Electric double layer capacitor) because LIC has high voltage range up to 3.8 V. But, many aspects of the electrochemical performance of LIC still need to be examined closely in order to apply for commercial use. In this study, in order to improve the capacitance of LIC related with energy density, we designed new method of pre-doping in anode electrode. The electrode in cathode were fabricated in dry room which has a relative humidity under 0.1% and constant electrode thickness over $100{\mu}m$ was manufactured for stable mechanical strength and anode doping. To minimize of contact resistance, fabricated electrode was conducted hot compression process from room temperature to $65^{\circ}C$. We designed various pre-doping method for LIC structure and analyzing the doping mechanism issues. Finally, we suggest new pre-doping method to improve the capacitance and electrochemical stability for LIC.

• Korean Journal of Heritage: History & Science
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• v.54 no.4
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• pp.152-173
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• 2021

The Large Banner was introduced during the Japanese Invasions of Korea with a new military system. It was a flag that controlled the movement of soldiers in military training. In addition, it was used in other ways, such as a symbol when receiving a king in a military camp, a flag raised on the front of a royal procession, at the reception and dispatch of envoys, and at a local official's procession. The Large Banner was recognized as a symbol of military dignity and training rites. The Large Banner was analyzed in the present study in the context of two different types of decorations. Type I includes chungdogi, gakgi and moongi. Type II includes grand, medium, and small obangi, geumgogi and pyomigi. Each type is decorated differently for each purpose. The size of the flag is estimated to be a square of over 4 ja long in length. Flame edges were attached to one side and run up and down The Large Banner used the Five Direction Colors based on the traditional principles of Yin-Yang and Five Elements. The pattern of the Large Banner is largely distinguished by four. The pattern of large obangi consists of divine beasts symbolizing the Five Directions and a Taoism amulet letter. The pattern of medium obangi features spiritual generals that escort the Five Directions. The pattern of small obangi has the Eight Trigrams. The pattern of moongi consists of a tiger with wings that keeps a tight watch on the army's doors. As for historical sources of coloring for Large Banner production, the color-written copy named Gije, from the collection of the Osaka Prefect Library, was confirmed as the style of the Yongho Camp in the mid to late 18th century, and it was also used for this essay and visualization work. We used Cloud-patterned Satin Damask as the background material for Large Banner production, to reveal the dignity of the military. The size of the 4 ja flag was determined to be 170 cm long and 145 cm wide, and the 5 ja flag was 200 cm long and 175 cm wide. The conversion formula used for this work was Youngjochuck (1 ja =30cm). In addition, the order of hierarchy in the Flag of the King was discovered within all flags of the late Joseon Dynasty. In the above historical study, the two types of Large Banner were visualized. The visualization considered the size of the flag, the decoration of the flagpole, and the patterns described in this essay to restore them to their original shape laid out the 18th century relics on the background. By presenting color, size, material patterns, and auxiliary items together, it was possible not only to produce 3D content, but also to produce real products.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.31 no.3
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• pp.101-114
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• 2019

In this study, we carry out the numerical simulation to trace the yearly shoreline change of Mang-Bang beach, which is suffering from erosion problem. We obtain the basic equation (One Line Model for shoreline) for the numerical simulation by assuming that the amount of shoreline retreat or advance is balanced by the net influx of longshore and cross-shore sediment into the unit discretized shoreline segment. In doing so, the energy flux model for the longshore sediment transport rate is also evoked. For the case of cross sediment transport, the modified Bailard's model (1981) by Cho and Kim (2019) is utilized. At each time step of the numerical simulation, we adjust a closure depth according to pertinent wave conditions based on the Hallermeier's analytical model (1978) having its roots on the Shield's parameter. Numerical results show that from 2017.4.26 to 2017.10.15 during which swells are prevailing, a shoreline advances due to the sustained supply of cross-shore sediment. It is also shown that a shoreline temporarily retreats due to the erosion by the yearly highest waves sequentially occurring from mid-October to the end of October, and is followed by gradual recovery of shoreline as high waves subdue and swells prevail. It is worth mentioning that great yearly circulation of shoreline completes when a shoreline retreats due to the erosion by the higher waves occurring from mid-March to the end of March. The great yearly circulation of shoreline mentioned above can also be found in the measured locations of shoreline on 2017.4.5, 2017.9.7, 2017.11.7, 2018.3.14. However, numerically simulated amount of shoreline retreat or advance is more significant than the physically measured one, and it should be noted that these discrepancies become more substantial for the case of RUN II where a closure depth is sustained to be as in the most morphology models like the Genesis (Hanson and Kraus, 1989).

• Korean Journal of Heritage: History & Science
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• v.55 no.1
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• pp.111-132
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• 2022

The comprehensive examination on tendering system has been introduced to the Cultural Heritage repair and restoration field since 2016 to remedy the repair issues of South Gate in 2014. The Cultural Heritage Administration tried to attain the high performance of the cultural heritage repair and restoration works securing the proper payment for the repair and restoration works. It is high time to review the operating performance of the comprehensive examination on tendering system (hereinafter referred to as the "CEOTS"), as the system has been run for over 5 years to correspond with its original goal, i.e., "The Proper Payment in return for the High Performance of Repair and Restoration works." This study intends to analyze 114 tenders of CEOTS from 2016 to 2020. As a result of the analysis of 114 tenders, firstly, more than half of bid winners were in the top 20% of repair & restoration capacity disclosure amount list, which mostly fulfilled the goal of 'attaining high performance.' Secondly, as the winning bid rate is decreasing from 86.847% in 2017 to 85.488% in 2020, the goal of 'guarantee of a proper payment' is not achieved yet. Thirdly, the influence of Economic Evaluation section in CEOTS has been grown since the change of scoring system in CEOTS in 2019. This study identifies two reasons why the winning bid rate of CEOTS has decreased. Firstly, it is caused by the fact that 'the group that got more than 1st place' and 'the first place group' that are more than half of the total bidders have the decreasing bidding rate trend as the years go by. Secondly, the exclusion rate of 'the group that got more than 1st place' is higher than the exclusion rate of 'the group that got less than 1st place', which means the expected winning rate would be lowered. It is proposed that the revision of CEOTS code is needed, i.e. easing the strict rule concerning the exclusion rate as well as setting up the lower bidding limit to prevent the excessive decreasing winning bid rate.

• Journal of agricultural medicine and community health
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• v.47 no.3
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• pp.166-180
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• 2022

Objective: This study evaluated the effects of a non-face-to-face obesity management program, implemented during the pandemic. Methods: The non-face-to-face obesity management program used the Intervention mapping protocol (IMP). The program was put into effect over the course of eight weeks, from September 14 to November 13, 2020 in 48 overweight and obese adults, who applied to participate through the Daegu Citizen Health Support Center. Results: IMP was first a needs assessment was conducted; second, goal setting for behavior change was established; third, evidence-based selection of arbitration method and performance strategy was performed; fourth, program design and validation; fifth, the program was run; and sixth, the results were evaluated. The average weight after participation in the program was reduced by 1.2kg, average WC decreased by 3cm, and average BMI decreased by 0.8kg/m² (p<0.05). The results of the health behavior survey showed a positive improvement in lifestyle factors, including average daily intake calories, fruit intake, and time spent in walking exercise before and after participation in the program. A statistically significant difference was seen (p<0.05). The satisfaction level for program process evaluation was high, at 4.57±0.63 point. Conclusion: The non-face-to-face obesity management program was useful for obesity management for adults in communities, as it enables individual counseling by experts and active participation through self-body measurement and recording without restriction by time and place. However, the program had some restrictions on participation that may relate to the age of the subject, such as skill and comfort in using a mobile app.