• Title/Summary/Keyword: service methods

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The Effect of Community- and Individual-Level Factors on Suicidal Ideation and Attempts: A Multilevel Analysis (2021년 지역사회건강조사를 활용한 지역사회 및 개인 수준의 요인이 자살 생각과 자살 시도에 미치는 영향: 다수준 분석)

  • So Young Ha;Jinhwan Kim;Haegyun Park;Youngsoo Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.32 no.1
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    • pp.24-33
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    • 2024
  • Objectives : The purpose of this study was to investigate individual- and community-level factors on suicidal ideation and suicide attempt among Korean adults. Methods : This study was conducted on 225,965 adults collected through data from the 2021 Community Health Survey and the Korean Statistical Information Service (KOSIS). The general characteristics, suicidal behavior (e.g., suicidal ideation, and suicide attempts), and community-level characteristics of the study subjects were analyzed using frequency (%) and mean (standard deviation). The effects on individual- and community-level factors on suicidal ideation and suicide attempts was analyzed using multilevel logistic regression models. Results : The community-level factor associated with suicidal ideation was unmet health care (Odds Ratio [OR]=1.053, 95% CI=1.035-1.071), and the community-level factor associated with suicide attempt was the aging rate (OR=1.015, 95% CI=1.001-1.030). Regarding health-related variables, the individual-level factors associated with suicidal ideation were stress status (OR=9.388, 95% CI=8.629-10.213), depressive experience in the past year (OR=6.737, 95% CI=6.454-7.032), and the predominantly individual-level factors associated with suicide attempt were also stress status (OR=5.213, 95% CI=3.699-7.347), and depressive experience in the last one year (OR=13.433, 95% CI: 11.247-16.044). Conclusions : We confirmed individual-level and community-level factors influencing suicidal ideation and suicide attempt. Through these findings, we need to establish suicide prevention policies, considering managing individual-level factors such as stress and depression as well as community-level factors such as unmet health care.

Vision-based Method for Estimating Cable Tension Using the Stay Cable Shape (사장재 케이블 형태를 이용하여 케이블 장력을 추정하는 영상기반 방법)

  • Jin-Soo Kim;Jae-Bong Park;Deok-Keun Lee;Dong-Uk Park;Sung-Wan Kim
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.28 no.1
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    • pp.98-106
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    • 2024
  • Due to advancements in construction technology and analytical tools, an increasing number of cable-stayed bridges have been designed and constructed in recent years. A cable is a structural element that primarily transmits the main load of a cable-stayed bridge and plays the most crucial role in reflecting the overall condition of the entire bridge system. In this study, a vision-based method was applied to estimate the tension of the stay cables located at a long distance. To measure the response of a cable using a vision-based method, it is necessary to install feature points or targets on the cable. However, depending on the location of the point to be measured, there may be no feature points in the cable, and there may also be limitations in installing the target on the cable. Hence, it is necessary to find a way to measure cable response that overcomes the limitations of existing vision-based methods. This study proposes a method for measuring cable responses by utilizing the characteristics of cable shape. The proposed method involved extracting the cable shape from the acquired image and determining the center of the extracted cable shape to measure the cable response. The extracted natural frequencies of the vibration mode were obtained using the measured responses, and the tension was estimated by applying them to the vibration method. To verify the reliability of the vision-based method, cable images were obtained from the Hwatae Bridge in service under ambient vibration conditions. The reliability of the method proposed in this study was confirmed by applying it to the vibration method using a vision-based approach, resulting in estimated tensions with an error of less than 1% compared to tensions estimated using an accelerometer.

A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

A Comparative Study on Reservoir Level Prediction Performance Using a Deep Neural Network with ASOS, AWS, and Thiessen Network Data

  • Hye-Seung Park;Hyun-Ho Yang;Ho-Jun Lee; Jongwook Yoon
    • Journal of the Korea Society of Computer and Information
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    • v.29 no.3
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    • pp.67-74
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    • 2024
  • In this paper, we present a study aimed at analyzing how different rainfall measurement methods affect the performance of reservoir water level predictions. This work is particularly timely given the increasing emphasis on climate change and the sustainable management of water resources. To this end, we have employed rainfall data from ASOS, AWS, and Thiessen Network-based measures provided by the KMA Weather Data Service to train our neural network models for reservoir yield predictions. Our analysis, which encompasses 34 reservoirs in Jeollabuk-do Province, examines how each method contributes to enhancing prediction accuracy. The results reveal that models using rainfall data based on the Thiessen Network's area rainfall ratio yield the highest accuracy. This can be attributed to the method's accounting for precise distances between observation stations, offering a more accurate reflection of the actual rainfall across different regions. These findings underscore the importance of precise regional rainfall data in predicting reservoir yields. Additionally, the paper underscores the significance of meticulous rainfall measurement and data analysis, and discusses the prediction model's potential applications in agriculture, urban planning, and flood management.

Occupational exposure to polycyclic aromatic hydrocarbons in Korean adults: evaluation of urinary 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, and 2-hydroxyfluorene using Second Korean National Environmental Health Survey data

  • Dong Hyun Hong;Jongwon Jung;Jeong Hun Jo;Dae Hwan Kim;Ji Young Ryu
    • Annals of Occupational and Environmental Medicine
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    • v.35
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    • pp.6.1-6.15
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    • 2023
  • Background: Polycyclic aromatic hydrocarbons (PAHs) are occupational and environmental pollutants generated by the incomplete combustion of organic matter. Exposure to PAHs can occur in various occupations. In this study, we compared PAH exposure levels among occupations based on 4 urinary PAH metabolites in a Korean adult population. Methods: The evaluation of occupational exposure to PAHs was conducted using Second Korean National Environmental Health Survey data. The occupational groups were classified based on skill types. Four urinary PAH metabolites were used to evaluate PAH exposure: 1-hydroxypyrene (1-OHP), 2-naphthol (2-NAP), 1-hydroxyphenanthrene (1-OHPHE), and 2-hydroxyfluorene (2-OHFLU). The fraction exceeding the third quartile of urinary concentration for each PAH metabolite was assessed for each occupational group. Adjusted odds ratios (ORs) for exceeding the third quartile of urinary PAH metabolite concentration were calculated for each occupational group compared to the "business, administrative, clerical, financial, and insurance" group using multiple logistic regression analyses. Results: The "guard and security" (OR: 2.949; 95% confidence interval [CI]: 1.300-6.691), "driving and transportation" (OR: 2.487; 95% CI: 1.418-4.364), "construction and mining" (OR: 2.683; 95% CI: 1.547-4.655), and "agriculture, forestry, and fisheries" (OR: 1.973; 95% CI: 1.220-3.191) groups had significantly higher ORs for 1-OHP compared to the reference group. No group showed significantly higher ORs than the reference group for 2-NAP. The groups with significantly higher ORs for 1-OHPHE than the reference group were "cooking and food service" (OR: 2.073; 95% CI: 1.208-3.556), "driving and transportation" (OR: 1.724; 95% CI: 1.059-2.808), and "printing, wood, and craft manufacturing" (OR: 2.255; 95% CI: 1.022-4.974). The OR for 2-OHFLU was significantly higher in the "printing, wood, and craft manufacturing" group (OR: 3.109; 95% CI: 1.335-7.241) than in the reference group. Conclusions: The types and levels of PAH exposure differed among occupational groups in a Korean adult population.

Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study

  • Saeyeon Kim;Tak Kyu Oh;In-Ae Song;Young-Tae Jeon
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.84-93
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    • 2024
  • Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

Epidemiologic Profile of Patients With Valvular Heart Disease in Korea: A Nationwide Hospital-Based Registry Study

  • You-Jung Choi;Jung-Woo Son;Eun Kyoung Kim;In-Cheol Kim;Hyung Yoon Kim;Jeong-Sook Seo;Byung Joo Sun;Chi Young Shim;Se-Jung Yoon;Sahmin Lee;Sun Hwa Lee;Jun-Bean Park;Duk-Hyun Kang
    • Journal of Cardiovascular Imaging
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    • v.31 no.1
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    • pp.51-61
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    • 2023
  • BACKGROUND: Valvular heart disease (VHD) is a common cause of cardiovascular morbidity and mortality worldwide; however, its epidemiological profile in Korea requires elucidation. METHODS: In this nationwide retrospective cohort study from the Korean valve survey, which collected clinical and echocardiographic data on VHD from 45 medical centers, we identified 4,089 patients with VHD between September and October 2019. RESULTS: The aortic valve was the most commonly affected valve (n = 1,956 [47.8%]), followed by the mitral valve (n = 1,598 [39.1%]) and tricuspid valve (n = 1,172 [28.6%]). There were 1,188 cases of aortic stenosis (AS) and 926 cases of aortic regurgitation. The most common etiology of AS was degenerative disease (78.9%). The proportion of AS increased with age and accounted for the largest proportion of VHD in patients aged 80-89 years. There were 1,384 cases of mitral regurgitation (MR) and 244 cases of mitral stenosis (MS). The most common etiologies for primary and secondary MR were degenerative disease (44.3%) and non-ischemic heart disease (63.0%), respectively, whereas rheumatic disease (74.6%) was the predominant cause of MS. There were 1,172 tricuspid regurgitation (TR) cases, of which 46.9% were isolated and 53.1% were associated with other valvular diseases, most commonly with MR. The most common type of TR was secondary (90.2%), while primary accounted for 6.1%. CONCLUSIONS: This report demonstrates the current epidemiological status of VHD in Korea. The results of this study can be used as fundamental data for developing Korean guidelines for VHD.

Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea

  • Yu Jin Lee;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Kyounghwan Kim;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.20-27
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    • 2024
  • Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study

  • Kevin Y. Zhu;Kristie J. Sun;Mary A. Breslin;Mark Kalina Jr.;Tyler Moon;Ryan Furdock;Heather A. Vallier
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.60-66
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    • 2024
  • Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

5G Network Resource Allocation and Traffic Prediction based on DDPG and Federated Learning (DDPG 및 연합학습 기반 5G 네트워크 자원 할당과 트래픽 예측)

  • Seok-Woo Park;Oh-Sung Lee;In-Ho Ra
    • Smart Media Journal
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    • v.13 no.4
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    • pp.33-48
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    • 2024
  • With the advent of 5G, characterized by Enhanced Mobile Broadband (eMBB), Ultra-Reliable Low Latency Communications (URLLC), and Massive Machine Type Communications (mMTC), efficient network management and service provision are becoming increasingly critical. This paper proposes a novel approach to address key challenges of 5G networks, namely ultra-high speed, ultra-low latency, and ultra-reliability, while dynamically optimizing network slicing and resource allocation using machine learning (ML) and deep learning (DL) techniques. The proposed methodology utilizes prediction models for network traffic and resource allocation, and employs Federated Learning (FL) techniques to simultaneously optimize network bandwidth, latency, and enhance privacy and security. Specifically, this paper extensively covers the implementation methods of various algorithms and models such as Random Forest and LSTM, thereby presenting methodologies for the automation and intelligence of 5G network operations. Finally, the performance enhancement effects achievable by applying ML and DL to 5G networks are validated through performance evaluation and analysis, and solutions for network slicing and resource management optimization are proposed for various industrial applications.