• Journal of Chest Surgery
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• 제57권3호
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• pp.302-311
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• 2024

Background: Unexpected conversion to thoracotomy during planned video-assisted thoracoscopic surgery (VATS) can lead to poor outcomes and comparatively high morbidity. This study was conducted to assess preoperative risk factors associated with unexpected thoracotomy conversion and to develop a risk scoring model for preoperative use, aimed at identifying patients with an elevated risk of conversion. Methods: A retrospective analysis was conducted of 1,506 patients who underwent surgical resection for non-small cell lung cancer. To evaluate the risk factors, univariate analysis and logistic regression were performed. A risk scoring model was established to predict unexpected thoracotomy conversion during VATS of the lung, based on preoperative factors. To validate the model, an additional cohort of 878 patients was analyzed. Results: Among the potentially significant clinical variables, male sex, previous ipsilateral lung surgery, preoperative detection of calcified lymph nodes, and clinical T stage were identified as independent risk factors for unplanned conversion to thoracotomy. A 6-point risk scoring model was developed to predict conversion based on the assessed risk, with patients categorized into 4 groups. The results indicated an area under the receiver operating characteristic curve of 0.747, with a sensitivity of 80.5%, specificity of 56.4%, positive predictive value of 1.8%, and negative predictive value of 91.0%. When applied to the validation cohort, the model exhibited good predictive accuracy. Conclusion: We successfully developed and validated a risk scoring model for preoperative use that can predict the likelihood of unplanned conversion to thoracotomy during VATS of the lung.

• 한국의류학회지
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• 제33권11호
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• pp.1707-1718
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• 2009

This study examines the effects of perceived risks on purchase decision behavior among Internet fashion consumers. The study survey used a self-administered questionnaire and a total data of 244 responses were used for analysis. The results of this study are as follows: First, the perceived risks consist of 6 factors, quality risk, counterfeit product risk, credit dealing risk, social/psychological risk, size and appearance risk, and delivery risk. The purchase decision behavior consist of 3 factors, delay of purchase decision, website switching, and offline conversion behavior. Second, purchase time positively affected the quality risk and credit dealing risk. Purchase frequency negatively affected the quality risk and credit dealing risk. Third, the quality risk, size and appearance risk, counterfeit product risk, and credit dealing risk positively affected the delay of purchase decisions. Quality risk and counterfeit product risk positively affected website switching. In addition, quality risk, social/psychological risk, and credit dealing risk positively affected the offline conversion behavior. Fourth, credit dealing risk negatively affected a short term purchase intention and the delivery risk negatively affected a long term purchase intention. The social/psychological risk and credit dealing risk negatively affected the repurchase intention.

• Journal of Chest Surgery
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• 제50권5호
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• pp.355-362
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• 2017

Background: Off-pump coronary artery bypass grafting (OPCABG) procedures can avoid the complications of an on-pump bypass. However, some cases unexpectedly require conversion to cardiopulmonary bypass during OPCABG. The risk factors associated with a sudden need for cardiopulmonary bypass were analyzed. Methods: This retrospective study included 283 subjects scheduled for OPCABG from 2001 to 2010. These were divided into an OPCABG group and an on-pump conversion group. Preoperative, operative, and postoperative variables were compared between the 2 groups. Results: Of the 283 patients scheduled for OPCABG, 47 (16%) were switched to on-pump coronary artery bypass grafting (CABG). The mortality of the both the OPCABG and on-pump conversion groups was not significantly different. The major risk factors for conversion to on-pump CABG were congestive heart failure (CHF) (odds ratio [OR], 3.5; p=0.029), ejection fraction (EF) <35% (OR, 4.4; p=0.012), and preoperative beta-blocker (BB) administration (OR, 0.3; p=0.007). The use of intraoperative (p=0.007) and postoperative (p=0.021) inotropics was significantly higher in the conversion group. The amount of postoperative drainage (p<0.001) and transfusion (p<0.001) also was significantly higher in the conversion group. There were no significant differences in stroke or cardiovascular complications between the groups over the course of short-term and long-term follow-up. Conclusion: Patients who undergo OPCABG and have CHF or a lower EF (<35%) are more likely to undergo on-pump conversion, while preoperative BB administration could help prevent conversions from OPCABG to on-pump CABG.

• Journal of Chest Surgery
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• 제50권1호
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.

• 한국유기농업학회지
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• 제15권1호
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• pp.1-23
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• 2007

It is hypothesized that changing from conventional to organic production is an investment because specific capital items are necessary for such a step. It is further hypothesized that in view of the limited experience and the very restricted availability of extension materials such investment is particularly prone to risk. The conversion to organic farming has proven to be an economically interesting alternative for a large portion of the converted farms in the past. This contribution will consider the question of which factors influence the success of organic farming. A discussion of the most important consequences for politics and agricultural practice conclude this paper, drawn on the important factors identified in the study.

• 융합정보논문지
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• 제10권8호
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• pp.187-193
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• 2020

본 연구는 우리나라 종합병원을 대상으로 경영의 위험요인이 운전자본 관리에 어떻게 영향을 미치는지를 분석하였다. 자료는 의료기관회계정보공시 시스템을 이용하여 271개 종합병원 3개연도(2016년, 2017년, 2018년)의 회계정보를 이용하였다. 도입변수는 종속변수로 운전자본 수준과 현금순환주기, 독립변수로 운영위험과 시장위험, 통제변수로 운전자금 구성요인(현금, 매출채권, 재고자산, 매입채무)을 선정하였다. 연구결과, 우리나라 종합병원들은 운영위험이 낮을수록 운전자본 수준은 높았으며, 운전자본 결정에는 운영위험, 현금, 재고자산, 매입채무가 작용하는 것으로 확인되었다. 그리고 시장위험(의료이익률)이 낮을수록 현금순환주기가 높았다는 것을 알 수 있었다. 따라서 의료기관들도 운영의 특수성을 고려하여 경기대응능력을 갖출 수 있도록 운전자본 결정요인으로 확인된 운영위험, 현금, 재고자산, 매입채무의 적절한 관리방안에 대한 검토의 필요성이 제기된다.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.470-478
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• 2020

본 연구에서는 단일 환산지수 체계를 유형별 외래 및 입원 환산지수로 분리하기 위한 이론 모형을 설계하였다. 그리고 가상 자료를 바탕으로 외래 및 입원 환산지수와 조정계수를 산출하였다. 본 연구에서의 중요한 결론은 다음과 같다. 첫째, 외래·입원 환산지수 개념을 도입하고 설계함으로써 의원은 외래, 병원은 중한 환자 위주의 입원 기능에 집중하도록 유도할 수 있는 최소한의 인센티브 도구를 도입할 수 있다. 둘째, 환산지수를 분리함으로써 상급종합병원을 비롯한 대형병원의 외래 진료비 수입이 목표 진료비 예산 이상으로 증가하더라도 병원수익 증대에 큰 도움이 되지 않도록 보상 체계를 설계할 수 있는 방안을 도입해 자원 배분 동기를 부여할 수 있다. 셋째, 단일 환산지수보다 다양한 요소들에 대한 명시적인 계약이 가능해져 급증하는 진료비에 대한 적절한 관리 수단으로 활용할 수 있다. 마지막으로 외래 및 입원 환산지수 분리 계약은 공급자의 행위론적인 변화를 유도해 의료전달체계를 정립하는데 기여할 수 있는 정책적인 도구로 활용될 수 있을 것이다.

• 한국임상수의학회지
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• 제32권1호
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• pp.78-84
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• 2015

Although researches have highlighted the important role of enhanced farm biosecurity to reduce the severity and prevalence of diseases in livestock, to date there has been little study in Korea on farmers' adoption of biosecurity measures to control porcine reproductive and respiratory syndrome virus (PRRSV) infection. To mitigate the risk of PRRSV infection in pigs, the risk factors by which PRRSV is introduced in pig farms must be determined. The primary aim of this study was to investigate pig producers' perceptions about on-farm biosecurity practices. We also analyzed data obtained from a cross-sectional study on 196 farrow-to-finish farms conducted between March 2013 and February 2014 to identify risk factors for PRRSV infection at farm level. Standardized questionnaires with information about basic demographical data and management practices were collected in each farm by on-site visit of trained veterinarians. Farms were classified as negative or positive through the use of infection profiles that combined data on PCR positive pigs and serological testing including antibody titer, sero-conversion pattern at each age category, and vaccination status. Data on biosecurity practices, farm management and environmental characteristics were analyzed using multivariate ordinal logistic regression. Generally, the biosecurity level in the pig farms included in this study were insufficient to reduce/prevent the risk of PRRSV infection given the high pig density areas and the considerable extent of vehicle movement. Factors associated with PRRSV infection were those where owners used on-farm vaccination programs had a lower risk of infection (OR = 0.19, 95% CI 0.06-0.61). The results from the analysis may guide to tailor biosecurity measures in the reduction or prevention of PRRS to the specific circumstances of pig farms in different localities of the world. To the best knowledge of the authors, this is the first study to report information on the biosecurity practices currently implemented on Korean pig farms.

• 무역학회지
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• 제47권6호
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• pp.71-96
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• 2022

This research will study the conversion intention of the users in China from fuel vehicle to new energy vehicles through the empirical methods. To this end, a questionnaire survey was conducted with car users as the object, combined with the theory of user migration and the PPM model to analyze the impact of fuel vehicle users' conversion intention to new-energy vehicles factor. The results showed that purchase experience contains the moderating effect, in which perceived risk and switching costs had a greater impact on the groups without purchase experience, whereas social identity, perceived value, personal attitude, and willingness to switch had a greater impact on groups with the purchase experience. Among all five factors, perceived risk had no discernible impact on the switching intention, but social identity, perceived value, attitude toward switching, and switching costs all had discernible impact on the switching intention. This study expects to come out with sustainable advises for the future growth of new energy vehicles from the study of car users' switching intention and the collective difference test of purchasing experience.

• 한국인터넷방송통신학회논문지
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• 제19권2호
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• pp.25-40
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• 2019

최근 많은 기업들이 대용량의 빅데이터 분석을 통하여 신사업을 발굴하거나 경영 및 기술 전략의 전환에 앞서 명시적인 근거를 마련하기 위하여 빅데이터 분석 및 활용을 위한 프로젝트를 수행하고 있다. 그러나 다수의 빅데이터 프로젝트가 정해진 기한 내에 종료를 못하여 실패하고 있음이 국내외적 문제로 대두되고 있다. 이는 공학적 관점에서 빅데이터 프로젝트의 위험 관리를 위한 지식 기반이 매우 미흡한 현 상황과 무관하지 않다. 따라서 본 논문에서는 빅데이터 구축 및 활용 프로젝트의 위험 요인을 분석하고, 중요도가 높은 위험 요인들을 도출한다. 이를 위해 문헌 연구로부터 프로젝트 위험 요인을 추출하고 친화도 기법을 통해 그룹화한 후 전문가 설문을 통해 중요도가 높은 위험 요인을 도출한다. 도출된 요인들을 대상으로 요인분석을 통해 빅데이터 프로젝트의 위험요인 분류표를 도출한다. 본 연구는 빅데이터 프로젝트에 대한 위험 식별, 위험 평가, 위험 분석을 위한 가장 기초가 되는 통제 지표의 개발이라는 데 큰 의미가 있으며, 향후 빅데이터 프로젝트와 관련된 효율적인 위험 관리의 이론적 근거를 제공함으로써 성공적인 빅데이터 프로젝트를 견인하는데 기초자료로써 크게 기여할 것으로 사료된다.