• Title/Summary/Keyword: relationship of outcomes

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Early and Midterm Results of Arterial Switch Operation for Double-Outlet Right Ventricle with Subpulmonary VSD (폐동맥하 심실증격결손을 동반한 양대혈관 우심실기시중에서 동맥전환술의 중단기 결과)

  • 양승인;이형두;김시호;조광조;우종수;이영석;성시찬
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.313-321
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    • 2004
  • Excellent clinical results of the arterial switch operation and the limited availablity of the intraventricular rerouting has recently made an arterial switch operation to become the therapeutic method of choice for the repair of double-outlet right ventricle (DORV) with subpulmonary ventricular septal defect (VSD). The early and midterm outcomes of arterial switch operation for this anomaly were evaluated. Material and Method: Between August 1994 and July 2002, 13 patients underwent an arterial switch operation for the correction of double-outlet right ventricle with subpulmonary VSD at Dong-A university hospital.. The 50% rule was used to define DORV. Median age and mean body weight were 27 days (range, 3-120 days) and 3.8$\pm$0.7kg (range, 2.92-5.3kg) respectively. Aortic arch anomalies were associated in 6 cases (46.2%), which were all repaired through one-stage operation. The relationship of the great arteries were side-by-side in 8 cases (61.5%) and anteroposterior in 5 (38.5%). Coronary artery patterns were 1 LCx-2R in 6 cases, retropulmonary left coronary artery (LCA) in 6, and intramural LCA in 1 respectively. The enlargement of VSD was required in 1 patient and the patch enlargement of right ventricular outflow tract was performed in another one patient. The Lecompte maneuver was used in all but 3 patients with a side by side relationship of the great arteries. Result: Overall postoperative hospital mortality was 23.1 % (3/13). All operative deaths were occurred in the patients with aortic arch anomalies. There was one late death related to the postoperative complication of the central nerve system during the mean follow-up of 41.3$\pm$30.7 months. Pulmonary valvar stenosis (>30mmHg of pressure gradient) developed in 1 patient (10%) and left pulmonary artery stenosis in 2 (20%), among them, one required reoperation 52 months after repair. There was an asymptomatic patient with moderate aortic regurgitation. 5-year survival rate including operative deaths was 68.3%. Conclusion: Although the operative mortality is high in the patients with aortic arch anomaly, the arterial switch operation for DORV with supbpulmonary VSD can be performed with low operative mortality and low reoperation rate in the patients Without arch anomaly. The arterial switch operation can be considered a good option for this complex anomaly.

The Impact of Innovative Efficiency on Performance of Firms (혁신효율성이 기업의 수익성에 미치는 영향)

  • Han, Ji-yeon;Ha, Seok-tae;Cho, Seong-pyo
    • Journal of Technology Innovation
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    • v.28 no.3
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    • pp.1-28
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    • 2020
  • This study examines whether the firm with high innovation efficiency realizes high operating performance. We measured innovation efficiency by the ratio of patent applications for R&D expenditure or R&D stock and measured operating performance by the ratio of operating income or operating cash flow to total assets for the following year. The sample consists of 1,880 manufacturing firm-years, which listed on the Korean Exchange between 2014 and 2017. We analyze the effect of innovation efficiency on operating performance using a model of Hirshleifer et al. (2013) results show that both innovation efficiency variables have a significantly positive relationship with the total asset operating margin. Besides, the following year's performance, measured by the total asset operating cash flow ratio, also shows a positive relationship with the two innovation efficiency variables at the 5% and 1% significance levels, respectively. The results indicate that high innovation efficiency firms that link the outcomes of R&D to more patent applications realize higher operating performance. Also, we divided the R&D-intensive and non-R&D-intensive industries and performed the same analysis. As a result, the innovation efficiency has a significant positive effect on operating margin in both industries. However, the effect of innovation efficiency on the operating cash flow is only significant in R&D-intensive industries. This study suggests that the effects of innovation efficiency are more consistent in the R&D-intensive industry. Additionally, we divided the high patent application and low patent applications industries and performed the same analysis. As a result, the innovation efficiency has a significant positive effect on operating margin in both industries. This study suggests that the effects of innovation efficiency are more consistent in the high patent application industry. We show that a firm's innovation efficiency is a critical factor for a firm's performance, while prior studies on the R&D performance have not considered the innovation efficiency of each firm. The evidence suggests that firms not only consider R&D expenditures but also improve the performance of companies by increasing innovation efficiency. Investors need to consider their innovation efficiency when evaluating the value of firms.

Mediating Roles of Attachment for Information Sharing in Social Media: Social Capital Theory Perspective (소셜 미디어에서 정보공유를 위한 애착의 매개역할: 사회적 자본이론 관점)

  • Chung, Namho;Han, Hee Jeong;Koo, Chulmo
    • Asia pacific journal of information systems
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    • v.22 no.4
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    • pp.101-123
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    • 2012
  • Currently, Social Media, it has widely a renown keyword and its related social trends and businesses have been fastly applied into various contexts. Social media has become an important research area for scholars interested in online technologies and cyber space and their social impacts. Social media is not only including web-based services but also mobile-based application services that allow people to share various style information and knowledge through online connection. Social media users have tendency to common identity- and bond-attachment through interactions such as 'thumbs up', 'reply note', 'forwarding', which may have driven from various factors and may result in delivering information, sharing knowledge, and specific experiences et al. Even further, almost of all social media sites provide and connect unknown strangers depending on shared interests, political views, or enjoyable activities, and other stuffs incorporating the creation of contents, which provides benefits to users. As fast developing digital devices including smartphone, tablet PC, internet based blogging, and photo and video clips, scholars desperately have began to study regarding diverse issues connecting human beings' motivations and the behavioral results which may be articulated by the format of antecedents as well as consequences related to contents that people create via social media. Social media such as Facebook, Twitter, or Cyworld users are more and more getting close each other and build up their relationships by a different style. In this sense, people use social media as tools for maintain pre-existing network, creating new people socially, and at the same time, explicitly find some business opportunities using personal and unlimited public networks. In terms of theory in explaining this phenomenon, social capital is a concept that describes the benefits one receives from one's relationship with others. Thereby, social media use is closely related to the form and connected of people, which is a bridge that can be able to achieve informational benefits of a heterogeneous network of people and common identity- and bonding-attachment which emphasizes emotional benefits from community members or friend group. Social capital would be resources accumulated through the relationships among people, which can be considered as an investment in social relations with expected returns and may achieve benefits from the greater access to and use of resources embedded in social networks. Social media using for their social capital has vastly been adopted in a cyber world, however, there has been little explaining the phenomenon theoretically how people may take advantages or opportunities through interaction among people, why people may interactively give willingness to help or their answers. The individual consciously express themselves in an online space, so called, common identity- or bonding-attachments. Common-identity attachment is the focus of the weak ties, which are loose connections between individuals who may provide useful information or new perspectives for one another but typically not emotional support, whereas common-bonding attachment is explained that between individuals in tightly-knit, emotionally close relationship such as family and close friends. The common identify- and bonding-attachment are mainly studying on-offline setting, which individual convey an impression to others that are expressed to own interest to others. Thus, individuals expect to meet other people and are trying to behave self-presentation engaging in opposite partners accordingly. As developing social media, individuals are motivated to disclose self-disclosures of open and honest using diverse cues such as verbal and nonverbal and pictorial and video files to their friends as well as passing strangers. Social media context, common identity- and bond-attachment for self-presentation seems different compared with face-to-face context. In the realm of social media, social users look for self-impression by posting text messages, pictures, video files. Under the digital environments, people interact to work, shop, learn, entertain, and be played. Social media provides increasingly the kinds of intention and behavior in online. Typically, identity and bond social capital through self-presentation is the intentional and tangible component of identity. At social media, people try to engage in others via a desired impression, which can maintain through performing coherent and complementary communications including displaying signs, symbols, brands made of digital stuffs(information, interest, pictures, etc,). In marketing area, consumers traditionally show common-identity as they select clothes, hairstyles, automobiles, logos, and so on, to impress others in any given context in a shopping mall or opera. To examine these social capital and attachment, we combined a social capital theory with an attachment theory into our research model. Our research model focuses on the common identity- and bond-attachment how they are formulated through social capitals: cognitive capital, structural capital, relational capital, and individual characteristics. Thus, we examined that individual online kindness, self-rated expertise, and social relation influence to build common identity- and bond-attachment, and the attachment effects make an impact on both the willingness to help, however, common bond seems not to show directly impact on information sharing. As a result, we discover that the social capital and attachment theories are mainly applicable to the context of social media and usage in the individual networks. We collected sample data of 256 who are using social media such as Facebook, Twitter, and Cyworld and analyzed the suggested hypotheses through the Structural Equation Model by AMOS. This study analyzes the direct and indirect relationship between the social network service usage and outcomes. Antecedents of kindness, confidence of knowledge, social relations are significantly affected to the mediators common identity-and bond attachments, however, interestingly, network externality does not impact, which we assumed that a size of network was a negative because group members would not significantly contribute if the members do not intend to actively interact with each other. The mediating variables had a positive effect on toward willingness to help. Further, common identity attachment has stronger significant on shared information.

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The Etiologies and Initial Antimicrobial Therapy Outcomes in One Tertiary Hospital ICU-admitted Patient with Severe Community-acquired Pneumonia (국내 한 3차 병원 중환자실에 입원한 중증지역획득폐렴 환자의 원인 미생물과 경험적 항균제 치료 성적의 고찰)

  • Lee, Jae Seung;Chung, Joo Won;Koh, Yunsuck;Lim, Chae-Man;Jung, Young Joo;Oh, Youn Mok;Shim, Tae Sun;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.522-529
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    • 2005
  • Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

State of Mind in the Flow 4-Channel Model and Play (플로우 4경로모형의 마음상태와 플레이(play))

  • Sohn, Jun-Sang
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.2
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    • pp.1-29
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    • 2007
  • The flow theory becomes one of the most important frameworks in the internet research arena. Hoffman and Novak proposed a hierarchical flow model showing the antecedents and outcomes of flow and the relationship among these variables in the hyper-media computer circumstances (Hoffman and Novak 1996). This model was further tested after their initial research (Novak, Hoffman, and Yung 2000). At their paper, Hoffman and Novak explained that the balance of challenge and skill leads to flow which means the positive optimal state of mind (Hoffman and Novak 1996). An imbalance between challenge and skill, leads to negative states of mind like anxiety, boredom, apathy (Csikszentmihalyi and Csikszentmihalyi 1988). Almost all research on the flow 4-channel model have been focusingon flow, the positive state of mind (Ellis, Voelkl, and Morris 1994 Mathwick and Rigdon 2004). However, it also needs to examine the formation of the negative states of minds and their outcomes. Flow researchers explain play or playfulness as antecedents or the early state of flow. However, play has been regarded as a distinct concept from flow in the flow literatures (Hoffman and Novak 1996; Novak, Hoffman, and Yung 2000). Mathwick and Rigdon discovered the influences of challenge and skill on play; they also observed the influence of play on web-loyalty and brand loyalty (Mathwick and Rigdon 2004). Unfortunately, they did not go so far as to test the influences of play on state of mind. This study focuses on the relationships between state of mind in the flow 4-channel model and play. Early research has attempted to hypothetically explain state of mind in flow theory, but has not been tested except flow until now. Also the importance of play has been emphasized in the flow theory, but has not been tested in the flow 4-channel model context. This researcher attempts to analyze the relationships among state of mind, skill of play, challenge, state of mind and web loyalty. For this objective, I developed a measure for state of mind and defined the concept of play as a trait. Then, the influences of challenge and skill on the state of mind and play under on-line shopping conditions were tested. Also the influences of play on state of mind were tested and those of flow and play on web loyalty were highlighted. 294 undergraduate students participated in this research survey. They were asked to respond about their perceptions of challenge, skill, state of mind, play, and web-loyalty to on-line shopping mall. Respondents were restricted to students who bought products on-line in a month. In case of buying products at two or more on-line shopping malls, they asked to respond about the shopping mall where they bought the most important one. Construct validity, discriminant validity, and convergent validity were used to check the measurement validations. Also, Cronbach's alpha was used to check scale reliability. A series of exploratory factor analyses was conducted. This researcher conducted confirmatory factor analyses to assess the validity of measurements. All items loaded significantly on their respective constructs. Also, all reliabilities were greater than.70. Chi-square difference tests and goodness of fit tests supported discriminant and convergent validity. The results of clustering and ANOVA showed that high challenge and high skill leaded to flow, low challenge and high skill leaded to boredom, and low challenge and low skill leaded to apathy. But, it was different from my expectation that high challenge and low skill didnot lead to anxiety but leaded to apathy. The results also showed that high challenge and high skill, and high challenge and low skill leaded to the highest play. Low challenge leaded to low play. 4 Structural Equation Models were built by flow, anxiety, boredom, apathy for analyzing not only the impact of play on state of mind and web-loyalty, but also that of state of mind on web-loyalty. According the analyses results of these models, play impacted flow and web-loyalty positively, but impacted anxiety, boredom, and apathy negatively. Results also showed that flow impacted web-loyalty positively, but anxiety, boredom, and apathy impacted web-loyalty negatively. The interpretations and implications of the test results of the hypotheses are as follows. First, respondents belonging to different clusters based on challenge and skill level experienced different states of mind such as flow, anxiety, boredom, apathy. The low challenge and low skill group felt the highest anxiety and apathy. It could be interpreted that this group feeling high anxiety or fear, then avoided attempts to shop on-line. Second, it was found that higher challenge leads to higher levels of play. Test results show that the play level of the high challenge and low skill group (anxiety group) was higher than that of the high challenge and high skill group (flow group). However, this was not significant. Third, play positively impacted flow and negatively impacted boredom. The negative impacts on anxiety and apathy were not significant. This means that the combination of challenge and skill creates different results. Forth, play and flow positively impacted web-loyalty, but anxiety, boredom, apathy had negative impacts. The effect of play on web-loyalty was stronger in case of anxiety, boredom, apathy group than fl ow group. These results show that challenge and skill influences state of mind and play. Results also demonstrate how play and flow influence web-loyalty. It implies that state of mind and play should be the core marketing variables in internet marketing. The flow theory has been focusing on flow and on the positive outcomes of flow experiences. But, this research shows that lots of consumers experience the negative state of mind rather than flow state in the internet shopping circumstance. Results show that the negative state of mind leads to low or negative web-loyalty. Play can have an important role with the web-loyalty when consumers have the negative state of mind. Results of structural equation model analyses show that play influences web-loyalty positively, even though consumers may be in the negative state of mind. This research found the impacts of challenge and skill on state of mind in the flow 4-channel model, not only flow but also anxiety, boredom, apathy. Also, it highlighted the role of play in the flow 4-channel model context and impacts on web-loyalty. However, tests show a few different results from hypothetical expectations such as the highest anxiety level of apathy group and insignificant impacts of play on anxiety and apathy. Further research needs to replicate this research and/or to compare 3-channel model with 4-channel model.

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The Effects of the Perceived Motivation Type toward Corporate Social Responsibility Activities on Customer Loyalty (기업사회책임활동적인지인지동기류형대고객충성도적영향(企业社会责任活动的认知认知动机类型对顾客忠诚度的影响))

  • Kim, Kyung-Jin;Park, Jong-Chul
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.5-16
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    • 2009
  • Corporate social responsibility (CSR) activities have been shown to be potential factors that can improve corporate image and increase the ability of corporations to compete. However, most previous studies related to CSR activities investigated how these activities influence product and corporate evaluation, as well as corporate image. In addition, some researchers treated consumers' perceptions of corporate motives as moderator variables in evaluating the relationship between corporate social responsibilities and consumer response. However, motive-based theories have some weaknesses. Corporate social responsibility activities cause two motives(egoistic vs. altruistic) for consumers, but recently, Vlachos et al. (2008) argued that these motives should be segmented. Thus, it is possible to transform the original theory into a modified theory model (persuasion knowledge model, PKM). Vlachos et al. (2008) segmented corporate social responsibility motives into four types and compared the effects of these motives on customer loyalty. Prior studies have proved that CSR activities with positive motives have positive influences on customer loyalty. However, the psychological reasons underlying this finding have not been determined empirically. Thus, the objectives of this research are twofold. First, we attempt to determine why most customers favor companies that they feel have positive motives for their corporate social responsibility activities. Second, we attempt to measure the effects of consumers' reciprocity when society benefits from corporate social responsibility activities. The following research hypotheses are constructed. H1: Values-driven motives for corporate social responsibility activities have a positive influence on the perceived reciprocity. H2: Stakeholder-driven motives for corporate social responsibility activities have a negative influence on the perceived reciprocity. H3: Egoistic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H4: Strategic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H5: Perceived reciprocity for corporate social responsibility activities has a positive influence on consumer loyalty. A single company is selected as a research subject to understand how the motives behind corporate social responsibility influence consumers' perceived reciprocity and customer loyalty. A total sample of 200 respondents was selected for a pilot test. In addition, to ensure a consistent response, we ensured that the respondents were older than 20 years of age. The surveys of 172 respondents (males-82, females-90) were analyzed after 28 invalid questionnaires were excluded. Based on our cutoff criteria, the model fit the data reasonably well. Values-driven motives for corporate social responsibility activities had a positive effect on perceived reciprocity (t = 6.75, p < .001), supporting H1. Morales (2005) also found that consumers appreciate a company's social responsibility efforts and the benefits provided by these efforts to society. Stakeholder-driven motives for corporate social responsibility activities did not affect perceived reciprocity (t = -.049, p > .05). Thus, H2 was rejected. Egoistic-driven motives (t = .3.11, p < .05) and strategic-driven (t = -4.65, p < .05) motives had a negative influence on perceived reciprocity, supporting H3 and H4, respectively. Furthermore, perceived reciprocity had a positive influence on consumer loyalty (t = 4.24, p < .05), supporting H5. Thus, compared with the general public, undergraduate students appear to be more influenced by egoistic-driven motives. We draw the following conclusions from our research findings. First, value-driven attributions have a positive influence on perceived reciprocity. However, stakeholder-driven attributions have no significant effects on perceived reciprocity. Moreover, both egoistic-driven attributions and strategic-driven attributions have a negative influence on perceived reciprocity. Second, when corporate social responsibility activities align with consumers' reciprocity, the efforts directed towards social responsibility activities have a positive influence on customer loyalty. In this study, we examine whether the type of motivation affects consumer responses to CSR, and in particular, we evaluate how CSR motives can influence a key internal factor (perceived reciprocity) and behavioral consumer outcome (customer loyalty). We demonstrate that perceived reciprocity plays a mediating role in the relationship between CSR motivation and customer loyalty. Our study extends the research on consumer CSR-inferred motivations, positing them as a direct indicator of consumer responses. Furthermore, we convincingly identify perceived reciprocity as a sub-process mediating the effect of CSR attributions on customer loyalty. Future research investigating the ultimate behavior and financial impact of CSR should consider that the impacts of CSR also stem from perceived reciprocity. The results of this study also have important managerial implications. First, the central role that reciprocity plays indicates that managers should routinely measure how much their socially responsible actions create perceived reciprocity. Second, understanding how consumers' perceptions of CSR corporate motives relate to perceived reciprocity and customer loyalty can help managers to monitor and enhance these consumer outcomes through marketing initiatives and management of CSR-induced attribution processes. The results of this study will help corporations to understand the relative importance of the four different motivations types in influencing perceived reciprocity.

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An Investigation on Expanding Co-occurrence Criteria in Association Rule Mining (연관규칙 마이닝에서의 동시성 기준 확장에 대한 연구)

  • Kim, Mi-Sung;Kim, Nam-Gyu;Ahn, Jae-Hyeon
    • Journal of Intelligence and Information Systems
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    • v.18 no.1
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    • pp.23-38
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    • 2012
  • There is a large difference between purchasing patterns in an online shopping mall and in an offline market. This difference may be caused mainly by the difference in accessibility of online and offline markets. It means that an interval between the initial purchasing decision and its realization appears to be relatively short in an online shopping mall, because a customer can make an order immediately. Because of the short interval between a purchasing decision and its realization, an online shopping mall transaction usually contains fewer items than that of an offline market. In an offline market, customers usually keep some items in mind and buy them all at once a few days after deciding to buy them, instead of buying each item individually and immediately. On the contrary, more than 70% of online shopping mall transactions contain only one item. This statistic implies that traditional data mining techniques cannot be directly applied to online market analysis, because hardly any association rules can survive with an acceptable level of Support because of too many Null Transactions. Most market basket analyses on online shopping mall transactions, therefore, have been performed by expanding the co-occurrence criteria of traditional association rule mining. While the traditional co-occurrence criteria defines items purchased in one transaction as concurrently purchased items, the expanded co-occurrence criteria regards items purchased by a customer during some predefined period (e.g., a day) as concurrently purchased items. In studies using expanded co-occurrence criteria, however, the criteria has been defined arbitrarily by researchers without any theoretical grounds or agreement. The lack of clear grounds of adopting a certain co-occurrence criteria degrades the reliability of the analytical results. Moreover, it is hard to derive new meaningful findings by combining the outcomes of previous individual studies. In this paper, we attempt to compare expanded co-occurrence criteria and propose a guideline for selecting an appropriate one. First of all, we compare the accuracy of association rules discovered according to various co-occurrence criteria. By doing this experiment we expect that we can provide a guideline for selecting appropriate co-occurrence criteria that corresponds to the purpose of the analysis. Additionally, we will perform similar experiments with several groups of customers that are segmented by each customer's average duration between orders. By this experiment, we attempt to discover the relationship between the optimal co-occurrence criteria and the customer's average duration between orders. Finally, by a series of experiments, we expect that we can provide basic guidelines for developing customized recommendation systems. Our experiments use a real dataset acquired from one of the largest internet shopping malls in Korea. We use 66,278 transactions of 3,847 customers conducted during the last two years. Overall results show that the accuracy of association rules of frequent shoppers (whose average duration between orders is relatively short) is higher than that of causal shoppers. In addition we discover that with frequent shoppers, the accuracy of association rules appears very high when the co-occurrence criteria of the training set corresponds to the validation set (i.e., target set). It implies that the co-occurrence criteria of frequent shoppers should be set according to the application purpose period. For example, an analyzer should use a day as a co-occurrence criterion if he/she wants to offer a coupon valid only for a day to potential customers who will use the coupon. On the contrary, an analyzer should use a month as a co-occurrence criterion if he/she wants to publish a coupon book that can be used for a month. In the case of causal shoppers, the accuracy of association rules appears to not be affected by the period of the application purposes. The accuracy of the causal shoppers' association rules becomes higher when the longer co-occurrence criterion has been adopted. It implies that an analyzer has to set the co-occurrence criterion for as long as possible, regardless of the application purpose period.

Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

Investigation of False Positive Rates Newborn Screening using Tandem Mass Spectrometry (TMS) Technology in Single Center (단일기관에서 이중 질량 분석법(tandem mass spectrometry technology)을 이용한 선천성 대사이상 검사의 위양성율에 대한 연구)

  • Kim, Hyunsoo;Shin, Son Moon;Ko, Sun Young;Lee, Yeon Kyung;Park, Sung Won
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.18-23
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    • 2016
  • Objective: Newborn screening leads to improved treatment and disease outcomes, but false-positive newborn screening results may impact include parental stress and anxiety, perception of child as unhealthy, parent-child relationship dysfunction, and increased infant hospitalizations. The purpose of this study was to investigate of the false positive rates and the causative factors of false positive results in Tandem Mass Spectrometry (TMS) in single center. Methods: Records were reviewed for all 18,872 subjects who were born in Cheill General Hospital, during January 1st, 2012 to December 31st, 2014. 17,292 neonates (91.62%) were tested for tandem mass screening almost in 2-5th day of life. Newborn babies whose first results were abnormal had been tested repeatedly by same methods in 7-14 day. If the results were abnormal again, further evaluation was performed. TMS analysis included data for the 43 disorders screened for using TMS broken down into three categories: fatty acid oxidation disorders, organic acidurias, and aminoacidopathies. The impact of several factors on increased false positive rates was analyzed using a multivariate analysis: time from birth to sample collection, birth weight, birth height, BMI, gender, gestational age, delivery type. Results: Males of the subjects were 8942 (51.7%), female 8350 (48.3%), the mean gestational age was $38.6{\pm}1.7$ weeks, the average birth weight $3,155.6{\pm}502.4g$, the average birth height $49.1{\pm}2.9cm$, and the average BMI $13.0{\pm}3.8(kg/m^2)$. Vaginal delivery cases were 9713 (56.2%), caesarean section 7,579 (43.8%). The average date of the inspection was $2.8{\pm}1.1$ days. 224 cases were identified as TMS positive. All the subjects were false positive (222/17,292, 1.30%) except 2 cases (1 male; benign phenylketonuria and 1 female; Short chain acyl-CoA dehydrogenase deficiency). The false positive rates were 0.61% in fatty acid oxidation disorders, 0.25% in organic acidurias, and 0.45% in aminoacidopathies. In our study, the date of inspection got late, the false positive rates got higher. Because almost the cases of late test date were in treatment in neonatal intensive care unit so their test date was affected by their medical conditions. False positive rate was higher in extreme immaturity${\leq}27$ weeks than newborns of gestational age >27 weeks [OR=6.957 (CI=1.273-38.008), p<0.025] and extremely low birth weight<1,000 g than newborns of birthweight ${\geq}1,000g$ [OR=5.616 (CI=1.134-27.820), p<0.035]. Conclusion: False positive rate of TMS was 1.30% in Cheil General Hospital. Lower gestational age and birth weight impacted on increased false positive rates. Better understanding of factors that influence the reporting of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting. of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting.

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Keyword Network Analysis for Technology Forecasting (기술예측을 위한 특허 키워드 네트워크 분석)

  • Choi, Jin-Ho;Kim, Hee-Su;Im, Nam-Gyu
    • Journal of Intelligence and Information Systems
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    • v.17 no.4
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    • pp.227-240
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    • 2011
  • New concepts and ideas often result from extensive recombination of existing concepts or ideas. Both researchers and developers build on existing concepts and ideas in published papers or registered patents to develop new theories and technologies that in turn serve as a basis for further development. As the importance of patent increases, so does that of patent analysis. Patent analysis is largely divided into network-based and keyword-based analyses. The former lacks its ability to analyze information technology in details while the letter is unable to identify the relationship between such technologies. In order to overcome the limitations of network-based and keyword-based analyses, this study, which blends those two methods, suggests the keyword network based analysis methodology. In this study, we collected significant technology information in each patent that is related to Light Emitting Diode (LED) through text mining, built a keyword network, and then executed a community network analysis on the collected data. The results of analysis are as the following. First, the patent keyword network indicated very low density and exceptionally high clustering coefficient. Technically, density is obtained by dividing the number of ties in a network by the number of all possible ties. The value ranges between 0 and 1, with higher values indicating denser networks and lower values indicating sparser networks. In real-world networks, the density varies depending on the size of a network; increasing the size of a network generally leads to a decrease in the density. The clustering coefficient is a network-level measure that illustrates the tendency of nodes to cluster in densely interconnected modules. This measure is to show the small-world property in which a network can be highly clustered even though it has a small average distance between nodes in spite of the large number of nodes. Therefore, high density in patent keyword network means that nodes in the patent keyword network are connected sporadically, and high clustering coefficient shows that nodes in the network are closely connected one another. Second, the cumulative degree distribution of the patent keyword network, as any other knowledge network like citation network or collaboration network, followed a clear power-law distribution. A well-known mechanism of this pattern is the preferential attachment mechanism, whereby a node with more links is likely to attain further new links in the evolution of the corresponding network. Unlike general normal distributions, the power-law distribution does not have a representative scale. This means that one cannot pick a representative or an average because there is always a considerable probability of finding much larger values. Networks with power-law distributions are therefore often referred to as scale-free networks. The presence of heavy-tailed scale-free distribution represents the fundamental signature of an emergent collective behavior of the actors who contribute to forming the network. In our context, the more frequently a patent keyword is used, the more often it is selected by researchers and is associated with other keywords or concepts to constitute and convey new patents or technologies. The evidence of power-law distribution implies that the preferential attachment mechanism suggests the origin of heavy-tailed distributions in a wide range of growing patent keyword network. Third, we found that among keywords that flew into a particular field, the vast majority of keywords with new links join existing keywords in the associated community in forming the concept of a new patent. This finding resulted in the same outcomes for both the short-term period (4-year) and long-term period (10-year) analyses. Furthermore, using the keyword combination information that was derived from the methodology suggested by our study enables one to forecast which concepts combine to form a new patent dimension and refer to those concepts when developing a new patent.