• Health Policy and Management
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• v.3 no.2
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• pp.159-176
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• 1993

The utilization of outpatient care services involves two steps of sequential decisions. The first step decision is about whether to initiate the utilization and the second one is about how many more visits to make after the initiation. Presumably, the initiation decision is largely made by the patient and his or her family, while the number of additional visits is decided under a strong influence of the physician. Implication is that the analysis of the outpatient care utilization requires to specify each of the two decisions underlying the utilization as a distinct stochastic process. This paper is concerned with the number of physician visits, which is, by definition, a discrete variable that can take only non-negative integer values. Since the initial visit is considered in the analysis of whether or not having made any physician visit, the focus on the number of visits made in addition to the initial one must be enough. The number of additional visits, being a kind of count data, could be assumed to exhibit a Poisson distribution. However, it is likely that the distribution is over dispersed since the number of physician visits tends to cluster around a few values but still vary widely. A recently reported study of outpatient care utilization employed an analysis based upon the assumption of a negative binomial distribution which is a type of overdispersed Poisson distribution. But there is an indication that the use of Poisson distribution making adjustments for over-dispersion results in less loss of efficiency in parameter estimation compared to the use of a certain type of distribution like a negative binomial distribution. An analysis of the data for outpatient care utilization was performed focusing on an assessment of appropriateness of available techniques. The data used in the analysis were collected by a community survey in Hwachon Gun, Kangwon Do in 1990. It was observed that a Poisson regression with adjustments for over-dispersion is superior to either an ordinary regression or a Poisson regression without adjustments oor over-dispersion. In conclusion, it seems the most approprite to assume that the number of physician visits made in addition to the initial visist exhibits an overdispersed Poisson distribution when outpatient care utilization is studied based upon a model which embodies the two-part character of the decision process uderlying the utilization.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.237-245
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• 2022

Objective: Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods: This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results: Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group (p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group (p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group (p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA (p = 0.030) and 0.705 for SWE (p = 0.035). Conclusion: Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

• Journal of Korean Institute of Industrial Engineers
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• v.32 no.1
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• pp.42-50
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• 2006

The multi-criteria group decision making (MCGDM) problem is to determine the best compromise solution in a set of competing alternatives that are evaluated under conflicting criteria by decision maker (DM)s. In this paper, we propose a mixed-integer programming (MIP) model to solve MCGDM. The existing method based on minimizing a distance measure such as Median Approach can not guarantee the best compromise solution because the element of median point vector is defined with respect to each criteria separately. However, by considering all criteria simultaneously, we generate median point that is better for locating the best compromise solution. We also utilize the concept of spatial dispersion index (SDI) to produce a threshold value, which is used as a guideline to choose either the Utopian Approach or the Median Approach. And we suggest using CBITP (Convex hull of individual maxima Based Interactive Tchebycheff Procedure) to provide DMs with various Pareto-optimal solutions so that DMs have broad range of selection.

• Structural Engineering and Mechanics
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• v.65 no.5
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• pp.633-644
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• 2018

This paper presents the results of an assessment of the seismic fragility of a long, curved multi-frame bridge under multi-support earthquake excitations. To achieve this aim, the numerical model of columns retrofitted with elliptical steel jackets was developed and validated using existing experimental results. A detailed nonlinear numerical model of the bridge that can capture the inelastic response of various components was then created. Using nonlinear time-history analyses for a set of stochastically generated spatially variable ground motions, component demands were derived and then convolved with new capacity-based limit state models to obtain seismic fragility curves. The comparison of failure probabilities obtained from uniform and multi-support excitation analyses revealed that the consideration of spatial variability significantly reduced the median value of fragility curves for most components except for the abutments. This observation indicates that the assumption of uniform motions may considerably underestimate seismic demands. Moreover, the spatial correlation of ground motions resulted in reduced dispersion of demand models that consequently decreased the dispersion of fragility curves for all components. Therefore, the spatial variability of ground motions needs to be considered for reliable assessment of the seismic performance of long multi-frame bridge structures.

• Korean Journal of Community Nutrition
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• v.6 no.3
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• pp.553-564
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• 2001

The purpose of this research was to observe the management system of 18 free meal service centers for the low-income homebound elderly in Chungcheongbuk-Do In order researchers interviewed staff members of the free meal service centers. Based on the results of interviews with staff members of the meal service organization. only two centers used a standard recipe. and most of the meal preparation was controlled under the experience of volunteers. Only two meal service centers employed dietitians due to the lak of budgets. The cost of a meal per day ranged from ￦ 556 to ￦2,750 and the number of attendants at meal service ranged from 35 to 350 persons. The budget for most of the meal service centers is not enough to provide meals for the elderly who want to participated in free meal service programs. Home delivery meal service was not considered due to the lake of manpower and areal dispersion in rural ares. Most meal service organizations did not cooperate with other community service organizations. Several improvement strategies are recommended for the effective running of the free meal service centers. First, a nutrition specialist should be included in the staff members of the service organization to provide nutritious meal service to the elderly Second, a joint control system might be introduced into the present system to reduced the cost and the recover the limitations of areal dispersion. Third, service, coordination should be considered to overcome the problem of lake resources.

• Journal of the korean Society of Automotive Engineers
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• v.13 no.2
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• pp.42-49
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• 1991

This study is to investigate the dispersion characteristics of diesel fuel spray in the initial stage of the beginning of the injection under the condition of room temperature and atmospheric pressure. It is difficult to analyse that the diesel fuel spray in diesel engine has unsteady intermittent spray. So author installed a fuel accumulator and an electromagnetic controller in order to keep the constant fuel injection rate with the time variation. With this modified fuel injection system, spray tip penetration, spray angle and initial spray development process are investigated by instantaneous photographic method. The results obtained in this study are as follows : 1) The initial shape of injection of diesel fuel spray shows the form of non-disintegrated intact core, but the formation of ligaments increasingly grows as the time increases. It can also be shown that fine droplets become disintegrated out from the ligaments. 2) The slope of spray tip penetration was changed to two different tendencies with time. The transition point of the slope is shown at the time of around between 0.09 msec and 0.4 msec from the beginning of injection. This is transition time from non-disintegrated intact core to formation of ligaments.

• Journal of the Korean Crystal Growth and Crystal Technology
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• v.19 no.2
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• pp.66-69
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• 2009

The compositional dependence of bismuth iron oxides and effect of La-substitutions in the structure of $BiFeO_3$ compounds were investigated, which compounds were synthesized by conventional ceramic processing. It is shown that some of bismuth iron oxides including $BiFeO_3$ show the narrow single phase region. The effect of La-doping in $BiFeO_3$ was presented as disappearance of many impurity phases of Bi-Fe-O compounds. The lower electrical resistivity was obtained as those compositions of Fe deficient region and La-doped $BiFeO_3$. The saturation magnetization of La-doped $BiFeO_3$ was increased with La content. The dielectric dispersion was also observed for those Bi-Fe-O compounds with Fe deficient and La-doped $BiFeO_3$ at low frequencies under 1 kHz.

• KCI Concrete Journal
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• v.13 no.2
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• pp.58-66
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• 2001

Recently, polymer-modified mortar has been studied for proposed use on industrial floors as top coat with thin thickness, typically 5~15mm. The purpose of this study is to evaluate basic properties of self-leveling materials using polymer dispersions as kinds of SBR, PAE, St/BA with thin coat (under 3mm). Superplasticizer and thickener have been included in the mixes to reduce bleeding and drying shrinkage as well as to facilitate the workability required. The self-leveling materials using four types of polymer dispersion are prepared with polymer-cement ratio which respectively range from 50% and 75%, and tested for basic characteristics such as unit weight, air content, flow, consistency change and adhesion in tension. From the test results, the self-leveling materials using PAE emulsion at curing age of 28days are almost equal to those of conventional floor using urethane and epoxy resin. The adhesion in tension of self-leveling mortars using SBR latex and PAE emulsion at curing age of 3days is over 17 kgf/cm$^2$(1.67MPa). Consistency change is strongly dependent on the type of polymer dispersion. It is concluded that the self-leveling materials using polymer dispersions can be used in the same manner as conventional floor using thermosetting resin in practical applications, in the selection of polymer dispersions.

• Journal of the Korea Institute of Building Construction
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• v.5 no.4 s.18
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• pp.115-120
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• 2005

In recent years, polymer-modified mortars using polymer dispersions have been widely used as finish and repair materials in the construction industry because of their excellent properties compares to those of ordinary cement mortar. Especially, the adhesion improvement of ordinary cement mortar and concrete has attracted a great deal of attention from researchers, and several unique and simply applicable techniques for the adhesion improvement have been developed. The purpose of this study is to evaluate the abrasion resistance of polymer-modified mortar according various curing methods. The polymer-modified mortar are prepared with various polymer-cement ratios, and are subjected to three curing methods such as dry rure, standard cure and freezing and thawing cure after two curing methods, and then tested for abrasion. From the test results, the polymer-modified mortars with various polymer-cement ratios have some superior abrasion resistance compared with plain mortar. The abrasion resistance of polymer-modified mortars increase with an increase in the polymer-cement ratio, and is better under water cure than any other curing methods. It is concluded that the abrasion resistance of cement mortar is markedly improved by modifying of polymer dispersion.

• Journal of the Korean Society for Heat Treatment
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• v.29 no.2
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• pp.51-55
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• 2016

The P/M processing of titanium aluminide using amorphous TiAl is developed by which it is possible to overcome inherent fabricability problems and to obtain a fine microstructure. A high quality amorphous TiAl powder produced by reaction ball milling shows clear glass transition far below a temperature at the onset of crystallization in differential scanning calorimetry above a heating rate of 0.05 K/s. We obtained a fully dense compact of amorphous TiAl powders, encapsulated in a vacuumed can, via viscous flow by hot isostatic pressing (HIP). Isothermally annealing of HIP'ed amorphous compact under a pressure of 196 MPa shows a progressive growth of ${\gamma}-TiAl$ phase with ${\alpha}2$ ($Ti_3Al$), which is characterized by increasing sharpness of X-ray peaks with temperature. Fully dense HIP'ed compact of titanium aluminide TiAl shows a high hardness of 505 Hv, suggesting strengthening mechanisms by sub-micron sized grain of ${\gamma}-TiAl$ and particle-dispersion by second phase constituent, ${\alpha}2$.