• Title/Summary/Keyword: Effectiveness

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A Domestic Outbreak of Bacterial Dysentery Caused by Extended-Spectrum β-Lactamase(ESBL)-producing Shigella sonnei (집단 발생한 Extended-spectrum β-lactamase(ESBL) 생산 Shigella sonnei 감염에 의한 세균성 이질에 관한 연구)

  • Lim, Hyun Taek;Lee, So Hee;Lee, Jung Hwa;Kim, Jeong Eun;Kim, Kyo Sun;Jeong, Eun Ju;Lee, Seung Hyun;Kang, Chang Gyu;Hong, Seong Jin
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1107-1115
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    • 2005
  • Purpose : An outbreak of ESBL-producing Shigella sonnei enteritis was unprecedented not only in Korea but throughout the world in the past. We intended to devise a management guideline for ESBL-producing shigellosis based on analysis of clinical manifestations and response to therapy. Methods : We analyzed 103 patients who were admitted to the hospital with acute GI symptoms and were shown positive result for S. sonnei on stool culture. We performed sensitivity test to the antibiotics and DNA sequencing of ESBL gene in the isolated S. sonnei colonies. In addition, we retrospectively analyzed their clinical characteristics, laboratory results, and clinical and microbiological responses to the antibiotics. Results : Among the clinical manifestations, fever was the most frequent(96.1%), followed by diarrhea(93.2%), abdominal pain(76.7%), headache(71.8%), vomiting(65.0%), and nausea(41.7%). The fever was sustained for average of 2.0 days and diarrhea for 3.9 days. Watery diarrhea was the most common(69%) followed by mucoid(26%), and bloody stool(5%). On peripheral blood smear, leukocytosis was noted in 53.4% of patients, and 78.6% of patients tested positive for serum CRP response. On stool direct smear, 11.7% of patients showed more than 50 WBCs/HPF, and 9.7% of patients between 5 to 20 WBCs/HPF. Stool occult blood was positive in 71% of patients. Production of CTX-M-14 type ESBL was reported for all S. sonnei strains isolated from this outbreak. Microbiological eradication rates to various antibiotics were as follows : 100%(9/9) to ciprofloxacin, 100% 5/5) to azithromycin, 6.9%(5/72) to cefdinir, 0%(0/8) to ceftriaxone, 12.5%(1/8) to ceftizoxime, 0%(0/ 8) to TMP/SMX, 42.9%(3/7) to ampicillin/sulbactam, 20%(1/5) to amoxicillin/clavulanic acid, and 68.8 %(11/16) to imipenem/cilastatin. Conclusion : It is presumed that azithromycin can be an attractive option for the treatment of ESBL-producing S. sonnei enteritis in pediatric population, given its cost-effectiveness and safety. Although ciprofloxacin is another cost-effective agent, its use in pediatric population may be a bit too premature.

Solitary Juvenile Polyps and Colonoscopic Polypectomy in Children (연소성 대장 용종의 내시경적 용종 절제술)

  • Cheon, Kyoung Whoon;Kim, Jae Young;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.236-241
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    • 2003
  • Purpose : This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. Methods : This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. Results : The mean age of the 19 cases was $4.7{\pm}2.8year$. The male to female ratio was 1 : 1.1. Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. Conclusion : Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.

Synergistic action of pesticide mixtures using glutathione-s-transferase- and esterase-inhibiting properties in diamondback moth (Plutella xylostella L.) (Glutathione-S-transferase와 esterase 효소 저해특성을 이용한 농약의 혼합 상승효과)

  • Yu, Yong-Man;Hong, S.S.;Kim, S.;Hur, J.H.
    • The Korean Journal of Pesticide Science
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    • v.7 no.1
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    • pp.38-44
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    • 2003
  • In vitro inhibitory activity of 34 insecticides and 31 fungicides to glutathione-S-transferase and esterases extracted from rats was determined. Of tested pesticides, the pesticides with high activity on both detoxifying enzymes were mixed with pesticides that are known to be detoxified by detoxifying enzymes. Glutathione-S-transferase was inhibited by thiodicarb $(I_{50}:1.87\times10^{-4}M)$, thiocyclam $(7.40\times10^{-4}M)$, dithianon $(7.55\times10^{-5}M)$, and tolylfluanide $(8.66\times10^{-5}M)$, while esterases by dichlorvos $(8.95\times10^{-8}M)$, pirimicarb $(2.74\times10^{-6}M)$, pyrazophos $(3.31\times10^{-5}M)$, and benomyl $(4.96\times10^{-5}M)$. After acephate known to be detoxified by glutathione-S-transferase was mixed with glutathione-S-transferase-inhibiting pesticides and phenthoate known to be detoxified by esterases was mixed with esterases-inhibiting pesticides, insecticidal activities of such mixtures were determined against diamondback moth (PlutelLa xylostella L.). Synergistic action was observed in all pesticide combinations. The highest synergistic action was obtained when phenthoate was combined with dichlorvos, showing that co-toxicity coefficients were 1512 and 1877 after 24 and 48 hours of treatment, respectively. Several other combinations of pesticides, such as phenthoate with benomyl, and acephate with dithianon, also showed synergism, showing that their co-toxicity coefficients were about 1,000 and 500, after 24 hours of treatment, respectively. Our results showed that combinations of pesticides inhibited by detoxifying enzymes and ones detoxified by detoxifying enzymes resulted in increased toxicities of pesticides, suggesting that such combinations could be used to develop pesticide mixtures with more broad spectrum and high effectiveness.

Estimation of Fetal Dose during Radiation Therapy of Pregnant Patient (임산부의 방사선치료 시 태아선량 평가)

  • Jung, Chi-Hoon;Kim, Chan-Yong;Kim, Bo-Gyum;Seo, Suk-Jin;Yoo, Sook-Hyun;Park, Heung-Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.1
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    • pp.35-41
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    • 2007
  • Purpose: To evaluate the effectiveness of a simple and practical shielding device to reduce the fetal dose for a pregnant patient undergoing radiation therapy of brain metastasis. Materials and Methods: The dose to the fetus was evaluated by simulating the treatments using the anthropomorphic phantom. The prescription dose at mid-brain is $300cGy{\times}10$ fractions with 6 MV photon with $18{\times}22cm^2$ field size. The additional shielding devices to reduce the fetal dose are a shielding wall, cerrobend plates and lead (Pb) sheets over acrylic bridge. Various points of measurement with off-field distance were detected by using ion-chamber (30, 40, 50, and 60 cm) with and without the shielding devices and TLD (30, 40, 50, 60, and 70 cm) only with the shielding devices. Results: The doses to the fetus without shielding were 3.20, 3.21, 1.44, 0.90 cGy at the distances of 30, 40, 50, and 60 cm from the treatment field edge. With shielding, the doses were reduced to 0.88, 0.60, 0.35, 0.25 cGy, and the ratio of the shielding effect varied from 70% to 80%. TLD results were 1.8, 1.2, 0.8, 1.2, and 0.8 cGy (70 cm). The total dose to the fetus was expected to be under 1 cGy during the entire treatment. Conclusion: The essential point during radiation therapy of pregnant patient would be minimizing the fetal dose. 10 cGy to 20 cGy is the threshold dose for fetal radiation effects. Our newly developed device reduced the fetal dose far below the safe level. Therefore, our additional shielding devices are useful and effective to reduce the fetal dose.

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A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease

  • Hyun, Seung-Jae;Yoon, Seung Hwan;Kim, Joo Han;Oh, Jae Keun;Lee, Chang-Hyun;Shin, Jun Jae;Kang, Jiin;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.562-574
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    • 2021
  • Objective : This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF). Methods : This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group. Post-operative observations were performed at 12, 24, and 48 weeks. The spinal fusion rate on computed tomography scans and X-rays films, Visual analog scale pain scores, Oswestry disability index and SF-36 quality of life (QOL) scores were used for the efficacy evaluation. The incidence rate of adverse device effects (ADEs) and serious adverse device effects (SADEs) were used for safety evaluation. Results : The spinal fusion rate at 12 weeks for the DBM gel with rhBMP-2 group was higher with 73.68% compared to 58.82% for the DBM gel group. The 24 and 48 weeks were 72.22% and 82.86% for the DBM gel with rhBMP-2 group and 78.79% and 78.13%, respectively, for the DBM gel group. However, there were no significant differences between two groups in the spinal fusion rate at 12, 24, and 48 weeks post-treatment (p=0.1817, p=0.5272, p=0.6247). There was no significant difference between the two groups in the incidence rate of ADEs (p=0.3836). For ADEs in the experimental group, 'Pyrexia' (5.00%) was the most common ADE, followed by 'Hypesthesia', 'Paresthesia', 'Transient peripheral paralysis', 'Spondylitis' and 'Insomnia' (2.50%, respectively). ADEs reported in control group included 'Pyrexia', 'Chest discomfort', 'Pain', 'Osteoarthritis', 'Nephropathy toxic', 'Neurogenic bladder', 'Liver function analyses' and 'Urticaria' (2.86%, respectively). There was no significant difference between the two groups in the incidence rate of SADEs (p=0.6594). For SADE in the experimental group, ''Pyrexia' and 'Spondylitis' were 2.50%. SADE reported in the control group included 'Chest discomfort', 'Osteoarthritis' and 'Neurogenic bladder'. All SADEs described above were resolved after medical treatment. Conclusion : This study demonstrated that the spinal fusion rates of DBM gel group and DBM gel with rhBMP-2 group were not significantly different. But, this study provides knowledge regarding the earlier postoperative effect of rhBMP-2 containing DBM gel and also supports the idea that the longer term follow-up results are essential to confirm the safety and effectiveness.

Evaluation of the sodium intake reduction plan for a local government and evidence-based reestablishment of objectives: Case of the Seoul Metropolitan Government (지자체의 나트륨 섭취 감소 계획 평가 및 근거 기반 목표 재설정 : 서울시 사례를 중심으로)

  • Lim, A-Hyun;Hwang, Ji-Yun;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.50 no.6
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    • pp.664-678
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    • 2017
  • Purpose: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. Methods: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. Results: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. Conclusion: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.

The effects of a personalized nutrition intervention program on food security, health and nutritional status of low-income older adults in Seoul city (서울시 일부 취약계층 노인에서 맞춤형 영양중재 프로그램에 따른 식품안정성 확보 및 건강·영양상태 개선 효과)

  • Lee, Yeyeon;Yang, Narae;Shin, Minjeong;Lee, Kyung-Eun;Yoo, Chang Hee;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.53 no.4
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    • pp.416-430
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    • 2020
  • Purpose: This study was conducted to assess the effects of a personalized nutritional intervention program on food security and health and nutritional status of elderly people in the city of Seoul. Methods: A total of 372 elderly adults aged 65 years or above who resided in Seoul were enrolled in this study. Personalized supplementary food supply and nutritional education based on chronic disease status, disability and cooking ability were implemented for 4 months. To evaluate the effectiveness of the program, nutrient intake, food security status, anemia status, chronic disease management, and frailty status, and prevalence of malnutrition (Mini Nutritional Assessment) were examined. Results: After the program, all subjects displayed significantly increased nutrient intake. Before the intervention, all subjects were in a state of food insecurity; however, after the intervention, 37.1% of the subjects were food secure. Moreover, the rates of being at risk of malnutrition and malnutrition in subjects were decreased and instead rate of those who improved to normal increased to 29.8% from 0% of normal rate before the prevention. The rate of subjects without anemia increased from 18.7% to 28.5% after the intervention. In addition, the rate of subjects with intensive or periodic management of chronic diseases decreased, while those with occasional management of chronic diseases increased from 0% to 4.6%. Furthermore, the rates of being at risk of frailty and frailty were decreased and the normal rate increased from 0% to 9.7% instead. Age group-based analysis showed that elderly people over 80 years showed less improvement in the management of the chronic disease status and the frailty status. Conclusion: Personalized supplementary food supplies and nutritional education improved not only the nutritional status but also disease status in vulnerable older adults, and the effects were more significant in adults aged less than 80 years.

A Study on Antecedents and the Consequences of Leadership Styles for Korean the Franchise System (프랜차이즈에서 리더십스타일의 선행요인과 성과요인에 관한 연구)

  • Lee, Eui-Joon;Kim, Sang-Deok
    • Journal of Distribution Science
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    • v.9 no.4
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    • pp.63-73
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    • 2011
  • The relationship between buyers and sellers is changing into a long-term relationship. A number of distribution channel researchers have determined that the behavior of distribution channel members can be characterized by relational exchanges. The members of relational distribution channels may be perceived as strategic partners; however, even within these arrangements, member asymmetries may exist, which can create unequal distributions of power and dependence. Thus, as all distribution channel members may not be equal in power, it is possible that a less-dependent channel leader may emerge. Therefore, leadership in distribution channels is a very important variable. Distribution channel leadership can be defined as the activities undertaken by the distribution channel leader to influence the marketing programs and strategies of channel members. A distribution channel's performance is influenced by the leadership style of the channel leader. Although research on channel leadership styles can be broadly categorized, many researchers have dealt with analyzing distribution channel leadership by using the power-influence approach, which includes looking at variables, such as power, power base, and influence strategies. Moreover, they have examined the direct relationship between leadership styles and performance. Many distribution channel scholars have attempted to justify the application of leadership styles identified in alternative leadership theories to the inter-organizational context of distribution channels. They have made suggestions regarding how great the usefulness of leadership style as a strategy is to secure the compliance of distribution channel members and have conceptually and empirically linked it to channel-related phenomena, such as manifest conflict, cooperation, channel efficiency, and effectiveness. However, as few empirical studies have examined the antecedents and consequences of leadership styles, research on leadership style can be considered nascent. Thus, it is required to investigate the antecedents and consequences of the leadership style of a distribution channel leader. This study aims to empirically identify whether there are influences of the antecedents of leadership on two different leadership styles, and to reveal whether these leadership styles induce any consequences. The research subjects were 220 franchisees. Research findings are as follows: First, the results show a positive effect of technological capability on transformational relationships. However, it does not have a significant effect on transactional leadership. Second, innovation-oriented organizational culture has negatively influenced both leaderships. However, task-oriented organizational culture positively and significantly influenced both forms of leadership. Third, the ethics of leaders has influenced both leadership styles positively and significantly. Fourth, regarding consequences, transformational leadership strengthens financial performances, whereas it weakens relational citizenship behaviors. However, transactional leadership positively influences relational citizenship behavior whilst negatively affecting financial performance.

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An Efficient Estimation of Place Brand Image Power Based on Text Mining Technology (텍스트마이닝 기반의 효율적인 장소 브랜드 이미지 강도 측정 방법)

  • Choi, Sukjae;Jeon, Jongshik;Subrata, Biswas;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.21 no.2
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    • pp.113-129
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    • 2015
  • Location branding is a very important income making activity, by giving special meanings to a specific location while producing identity and communal value which are based around the understanding of a place's location branding concept methodology. Many other areas, such as marketing, architecture, and city construction, exert an influence creating an impressive brand image. A place brand which shows great recognition to both native people of S. Korea and foreigners creates significant economic effects. There has been research on creating a strategically and detailed place brand image, and the representative research has been carried out by Anholt who surveyed two million people from 50 different countries. However, the investigation, including survey research, required a great deal of effort from the workforce and required significant expense. As a result, there is a need to make more affordable, objective and effective research methods. The purpose of this paper is to find a way to measure the intensity of the image of the brand objective and at a low cost through text mining purposes. The proposed method extracts the keyword and the factors constructing the location brand image from the related web documents. In this way, we can measure the brand image intensity of the specific location. The performance of the proposed methodology was verified through comparison with Anholt's 50 city image consistency index ranking around the world. Four methods are applied to the test. First, RNADOM method artificially ranks the cities included in the experiment. HUMAN method firstly makes a questionnaire and selects 9 volunteers who are well acquainted with brand management and at the same time cities to evaluate. Then they are requested to rank the cities and compared with the Anholt's evaluation results. TM method applies the proposed method to evaluate the cities with all evaluation criteria. TM-LEARN, which is the extended method of TM, selects significant evaluation items from the items in every criterion. Then the method evaluates the cities with all selected evaluation criteria. RMSE is used to as a metric to compare the evaluation results. Experimental results suggested by this paper's methodology are as follows: Firstly, compared to the evaluation method that targets ordinary people, this method appeared to be more accurate. Secondly, compared to the traditional survey method, the time and the cost are much less because in this research we used automated means. Thirdly, this proposed methodology is very timely because it can be evaluated from time to time. Fourthly, compared to Anholt's method which evaluated only for an already specified city, this proposed methodology is applicable to any location. Finally, this proposed methodology has a relatively high objectivity because our research was conducted based on open source data. As a result, our city image evaluation text mining approach has found validity in terms of accuracy, cost-effectiveness, timeliness, scalability, and reliability. The proposed method provides managers with clear guidelines regarding brand management in public and private sectors. As public sectors such as local officers, the proposed method could be used to formulate strategies and enhance the image of their places in an efficient manner. Rather than conducting heavy questionnaires, the local officers could monitor the current place image very shortly a priori, than may make decisions to go over the formal place image test only if the evaluation results from the proposed method are not ordinary no matter what the results indicate opportunity or threat to the place. Moreover, with co-using the morphological analysis, extracting meaningful facets of place brand from text, sentiment analysis and more with the proposed method, marketing strategy planners or civil engineering professionals may obtain deeper and more abundant insights for better place rand images. In the future, a prototype system will be implemented to show the feasibility of the idea proposed in this paper.

A Collaborative Filtering System Combined with Users' Review Mining : Application to the Recommendation of Smartphone Apps (사용자 리뷰 마이닝을 결합한 협업 필터링 시스템: 스마트폰 앱 추천에의 응용)

  • Jeon, ByeoungKug;Ahn, Hyunchul
    • Journal of Intelligence and Information Systems
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    • v.21 no.2
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    • pp.1-18
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    • 2015
  • Collaborative filtering(CF) algorithm has been popularly used for recommender systems in both academic and practical applications. A general CF system compares users based on how similar they are, and creates recommendation results with the items favored by other people with similar tastes. Thus, it is very important for CF to measure the similarities between users because the recommendation quality depends on it. In most cases, users' explicit numeric ratings of items(i.e. quantitative information) have only been used to calculate the similarities between users in CF. However, several studies indicated that qualitative information such as user's reviews on the items may contribute to measure these similarities more accurately. Considering that a lot of people are likely to share their honest opinion on the items they purchased recently due to the advent of the Web 2.0, user's reviews can be regarded as the informative source for identifying user's preference with accuracy. Under this background, this study proposes a new hybrid recommender system that combines with users' review mining. Our proposed system is based on conventional memory-based CF, but it is designed to use both user's numeric ratings and his/her text reviews on the items when calculating similarities between users. In specific, our system creates not only user-item rating matrix, but also user-item review term matrix. Then, it calculates rating similarity and review similarity from each matrix, and calculates the final user-to-user similarity based on these two similarities(i.e. rating and review similarities). As the methods for calculating review similarity between users, we proposed two alternatives - one is to use the frequency of the commonly used terms, and the other one is to use the sum of the importance weights of the commonly used terms in users' review. In the case of the importance weights of terms, we proposed the use of average TF-IDF(Term Frequency - Inverse Document Frequency) weights. To validate the applicability of the proposed system, we applied it to the implementation of a recommender system for smartphone applications (hereafter, app). At present, over a million apps are offered in each app stores operated by Google and Apple. Due to this information overload, users have difficulty in selecting proper apps that they really want. Furthermore, app store operators like Google and Apple have cumulated huge amount of users' reviews on apps until now. Thus, we chose smartphone app stores as the application domain of our system. In order to collect the experimental data set, we built and operated a Web-based data collection system for about two weeks. As a result, we could obtain 1,246 valid responses(ratings and reviews) from 78 users. The experimental system was implemented using Microsoft Visual Basic for Applications(VBA) and SAS Text Miner. And, to avoid distortion due to human intervention, we did not adopt any refining works by human during the user's review mining process. To examine the effectiveness of the proposed system, we compared its performance to the performance of conventional CF system. The performances of recommender systems were evaluated by using average MAE(mean absolute error). The experimental results showed that our proposed system(MAE = 0.7867 ~ 0.7881) slightly outperformed a conventional CF system(MAE = 0.7939). Also, they showed that the calculation of review similarity between users based on the TF-IDF weights(MAE = 0.7867) leaded to better recommendation accuracy than the calculation based on the frequency of the commonly used terms in reviews(MAE = 0.7881). The results from paired samples t-test presented that our proposed system with review similarity calculation using the frequency of the commonly used terms outperformed conventional CF system with 10% statistical significance level. Our study sheds a light on the application of users' review information for facilitating electronic commerce by recommending proper items to users.