• Title/Summary/Keyword: severity classification

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An integrated risk-informed safety classification for unique research reactors

  • Jacek Kalowski;Karol Kowal
    • Nuclear Engineering and Technology
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    • v.55 no.5
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    • pp.1814-1820
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    • 2023
  • Safety classification of systems, structures, and components (SSC) is an essential activity for nuclear reactor design and operation. The current regulatory trend is to require risk-informed safety classification that considers first, the severity, but also the frequency of SSC failures. While safety classification for nuclear power plants is covered in many regulatory and scientific publications, research reactors received less attention. Research reactors are typically of lower power but, at the same time, are less standardized i.e., have more variability in the design, operational modes, and operating conditions. This makes them more challenging when considering safety classification. This work presents the Integrated Risk-Informed Safety Classification (IRISC) procedure which is a novel extension of the IAEA recommended process with dedicated probabilistic treatment of research reactor designs. The article provides the details of probabilistic analysis performed within safety classification process to a degree that is often missing in most literature on the topic. The article presents insight from the implementation of the procedure in the safety classification for the MARIA Research Reactor operated by the National Center for Nuclear Research in Poland.

Comparison of Risk Factors for Men and Women According to Severity Classification in Patients with Coronary Artery Disease (관상동맥질환 중증도 분류에 따른 성별 위험요인 비교)

  • Kweon, Mi-Soo
    • Journal of Industrial Convergence
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    • v.20 no.8
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    • pp.85-96
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    • 2022
  • The aim of this retrospective study was to compare risk factors between men and women through secondary data of nursing information and medical records according to the severity classification in patients of 340 men and 221 women with coronary artery disease(CAD) who were admitted for the first time at a general hospital and underwent first coronary artery angiography. Consequently, men presented with risk factors such as age(p=.004), total cholesterol(p=.040), triglycerides(p=.049), HbA1c(p<.001), smoking(p<.001), alcohol consumption(p=.002) and comorbidities(p=.036) that showed statistically significant differences. Among women, age(p=.002) and comorbidities (p=.018) were the only factors that showed significant differences. Significant risk factors influencing the classification of CAD severity in men were total cholesterol (OR 0.97, 95% CI 0.96-1.00, p=.014) in 1VD, alcohol consumption (OR 52.47, 95% CI 2.99-91.95, p=.007)in 2VD, and total cholesterol in the 3VD(OR 0.98, 95% CI 0.95-0.98, p=.026). A significant risk factor affecting the classification of CAD severity in women was comorbidity (OR 0.30, 95% CI 0.11-0.82, p=.020) in the 3VD. This study identified the importance of nursing care for male CAD patients, such as smoking cessation and quitting drinking, blood sugar control, cholesterol, and accompanying disease management, and provided evidence of individually tailored nursing care.

Applicability of Thoracolumbar Injury Classification and Severity Score to Criteria of Korean Health Insurance Review and Assessment Service in Treatment Decision of Thoracolumbar Injury

  • Choi, Hyuk Jin;Kim, Hwan Soo;Nam, Kyoung Hyup;Cho, Won Ho;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • v.57 no.3
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    • pp.174-177
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    • 2015
  • Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

Establishing meteorological drought severity considering the level of emergency water supply (비상급수의 규모를 고려한 기상학적 가뭄 강도 수립)

  • Lee, Seungmin;Wang, Wonjoon;Kim, Donghyun;Han, Heechan;Kim, Soojun;Kim, Hung Soo
    • Journal of Korea Water Resources Association
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    • v.56 no.10
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    • pp.619-629
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    • 2023
  • Recent intensification of climate change has led to an increase in damages caused by droughts. Currently, in Korea, the Standardized Precipitation Index (SPI) is used as a criterion to classify the intensity of droughts. Based on the accumulated precipitation over the past six months (SPI-6), meteorological drought intensities are classified into four categories: concern, caution, alert, and severe. However, there is a limitation in classifying drought intensity solely based on precipitation. To overcome the limitations of the meteorological drought warning criteria based on SPI, this study collected emergency water supply damage data from the National Drought Information Portal (NDIP) to classify drought intensity. Factors of SPI, such as precipitation, and factors used to calculate evapotranspiration, such as temperature and humidity, were indexed using min-max normalization. Coefficients for each factor were determined based on the Genetic Algorithm (GA). The drought intensity based on emergency water supply was used as the dependent variable, and the coefficients of each meteorological factor determined by GA were used as coefficients to derive a new Drought Severity Classification Index (DSCI). After deriving the DSCI, cumulative distribution functions were used to present intensity stage classification boundaries. It is anticipated that using the proposed DSCI in this study will allow for more accurate drought intensity classification than the traditional SPI, supporting decision-making for disaster management personnel.

A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

Gene Regulations in HBV-Related Liver Cirrhosis Closely Correlate with Disease Severity

  • Lee, Se-Ram;Kim, So-Youn
    • BMB Reports
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    • v.40 no.5
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    • pp.814-824
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    • 2007
  • Liver cirrhosis (LC) is defined as comprising diffuse fibrosis and regenerating nodules of the liver. The biochemical and anatomical dysfunction in LC results from both reduced liver cell number and portal vascular derangement. Although several studies have investigated dysregulated genes in cirrhotic nodules, little is known about the genes implicated in the pathophysiologic change of LC or about their relationship with the degree of decompensation. Here, we applied cDNA microarray analysis using 38 HBsAg-positive LC specimens to identify the genes dysregulated in HBV-associated LC and to evaluate their relation to disease severity. Among 1063 known cancer- and apoptosis-related genes, we identified 104 genes that were significantly up- (44) or down- (60) regulated in LC. Interestingly, this subset of 104 genes was characteristically correlated with the degree of decompensation, called the Pugh-Child classification (20 Pugh-Child A, 10 Pugh-Child B, and 8 Pugh-Child C). Patient samples from Pugh-Child C exhibited a distinct pattern of gene expression relative to those of Pugh-Child A and B. Especially in Pugh-Child C, genes encoding hepatic proteins and metabolizing enzymes were significantly down-regulated, while genes encoding various molecules related to cell replication were up-regulated. Our results suggest that subsets of genes in liver cells correspond to the pathophysiologic change of LC according to disease severity and possibly to hepatocarcinogenesis.

Non-Operatively Treated Thoracolumbar Burst Fracture with Posterior Ligamentous Complex Injury: Case Report and Consideration on the Limitation of Thoracolumbar Injury Classification and Severity (TLICS) Score

  • Kwon, Woo-Keun;Oh, Jong-Keon;Cho, Jun-Min;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo Han
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.76-81
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    • 2018
  • Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.

Comparative Analysis of Terminology and Classification Related to Risk Management of Radiotherapy

  • Oh, Yoonjin;Kim, Dong Wook;Shin, Dong Oh;Koo, Jihye;Lee, Soon Sung;Choi, Sang Hyoun;Ahn, Sohyun;Park, Dong-wook
    • Progress in Medical Physics
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    • v.27 no.3
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    • pp.131-138
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    • 2016
  • We analyzed the terminology and classification related to the risk management of radiation treatment overseas to establish the terminology and classification system for Korea. This study investigated the terminology and classification for radiotherapy risk management through overseas research materials from related organizations and associations, including the IAEA, WHO, British group, EC, and AAPM. Overseas risk management commonly uses the terms "near miss", "incident", and "adverse event", classified according to the degree of severity. However, several organizations have ambiguous terminologies. They use the term "near miss" for events such as a near event, close call, and good catch; the term "incident" for an event; and the term "adverse event" for the likes of an accident and an event. In addition, different organizations use different classifications: a "near miss" is generally classified as "incident" in most cases but not classified as such in BIR et al. Confusion might also be caused by the disunity of the terminology and classification, and by the ambiguity of definitions. Patient safety management of medical institutions in Korea uses the terms "near miss", "adverse event", and "sentinel event", which it classifies into eight levels according to the severity of risk to the patient. Therefore, the terminology and classification for radiotherapy risk management based on the patient safety management of medical institutions in Korea will help in improving the safety and quality of radiotherapy.

Computed Tomographic Classification and Operative Treatment of Intraarticular Calcaneal Fractures (관절내 종골 골절의 전산화 단층촬영에 따른 분류 및 수술적 치료)

  • Roh, Jae-Young;Bae, Su-Young;Kim, Sung-Dug
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.149-155
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    • 2002
  • Purpose: To propose a new comprehensive classification system of intraarticular calcaneal fracture based on CT images. Materials and methods: Fourty intraarticular calcaneal fractures which were treated operatively were evaluated retrospectively. We classified fracture types according to severity of comminution on the posterior facet and calcaneocuboid joint by CT images. And we evaluated postoperative results of each fracture types in terms of the quality of fixation and reduction by the postoperative plain radiograghs. Results: By the classification of the posterior facet, 18 cases were P-I, 15 were P-II, and 7 were P-III. Among the P-I cases, 7 were P-IA, 9 were P-IL, 1 was P-IM and 2 were P-IT. According to the classification of calcaneocuboid joint, II cases were C-I, 18 were C-II and 11 were C-III. Qualities of fixation were excellent in 27 cases (67.5%), fair in 9(22.5%) and poor in 4(10%). Qualities of reduction were excellent 23 cases(57.5%), fair in 11(27.5%) and poor in 6(15%). Conclusion: Our new classification system based on the CT images could provide informations about the fracture configuration and severity of comminution around calcaneocuboid joint as well as the posterior facet. And the high grade fractures such as type P-III are need to be taken care of fixation of articular surfaces.

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