• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.1895-1904
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• 2014

This study explores the way to improve service quality with the application of Service Blueprint and Analytic Hierarchy Process (hereafter, "AHP") in medical tourism. Service Blueprint has been widely accepted to identify the possible fail points in service delivery system, and AHP analysis has been recognized as beneficial method to rate relative importance in multi-criteria decision making process. We try to understand possible pitfalls to enhance Chinese medical tourists, and propose the priority in the resolution process. In the first step, we reviewed the extant literatures about medical tourism of South Korea, and built initial Service Blueprint. Experts who experienced service delivery process towards Chinese patients participated to review the proposed Service Blueprint in the second step. Thirdly, after extracting the possible fail points from revised Service Blueprint, we asked experts to guess the relative importance of Chinese patient by AHP methodology. Four domains (Arrival and Welcoming, Hospitalization, Process before, operations, and after surgery, Recovery and discharge) were emerged with detail criteria. Results show that operations and treatment is the most important domain not to lose Chinese patient's loyalty with following hospitalization process domain. Also, we suggest the priority among sixteen criteria to prevent service failure.

• Molecules and Cells
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• v.40 no.5
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• pp.371-377
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• 2017

Despite the importance of the receptor activator of nuclear factor (NF)-kappaB ligand (RANKL)-RANK signaling mechanisms on osteoclast differentiation, little has been studied on how RANK expression is regulated or what regulates its expression during osteoclastogenesis. We show here that insulin signaling increases RANK expression, thus enhancing osteoclast differentiation by RANKL. Insulin stimulation induced RANK gene expression in time- and dose-dependent manners and insulin receptor shRNA completely abolished RANK expression induced by insulin in bone marrow-derived monocyte/macrophage cells (BMMs). Moreover, the addition of insulin in the presence of RANKL promoted RANK expression. The ability of insulin to regulate RANK expression depends on extracellular signal-regulated kinase 1/2 (ERK1/2) since only PD98059, an ERK1/2 inhibitor, specifically inhibited its expression by insulin. However, the RANK expression by RANKL was blocked by all three mitogen-activated protein (MAP) kinases inhibitors. The activation of RANK increased differentiation of BMMs into tartrate-resistant acid phosphatase-positive ($TRAP^+$) osteoclasts as well as the expression of dendritic cell-specific transmembrane protein (DC-STAMP) and d2 isoform of vacuolar ($H^+$) ATPase (v-ATPase) Vo domain (Atp6v0d2), genes critical for osteoclastic cell-cell fusion. Collectively, these results suggest that insulin induces RANK expression via ERK1/2, which contributes to the enhancement of osteoclast differentiation.

• Journal of Biomedical Engineering Research
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• v.44 no.6
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• pp.428-442
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• 2023

In this study, we have a goal to develop usability evaluation guidelines for heuristic-based artificial intelligence-based Software as a Medical Device (SaMD) in the medical field. We conducted a gap analysis between medical hardware (H/W) and non-medical software (S/W) based on ten heuristic principles. Through severity assessments, we identified 69 evaluation domains and 112 evaluation criteria aligned with the ten heuristic principles. Subsequently, we categorized each evaluation domain into five types, including user safety, data integrity, regulatory compliance, patient therapeutic effectiveness, and user convenience. We proposed usability evaluation guidelines that apply the newly derived heuristic-based Software as a Medical Device (SaMD) evaluation factors to the risk management process. In the discussion, we also have proposed the potential applications of the research findings and directions for future research. We have emphasized the importance of the judicious application of AI technology in the medical field and the evaluation of usability evaluation and offered valuable guidelines for various stakeholders, including medical device manufacturers, healthcare professionals, and regulatory authorities.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.515-534
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• 2002

Purpose : This study was to provide a meaningful framework for establishment of the direction of Nursing Management area to get ready for Nursing Personal Licensing Examination Board. Method : Using methodological and descriptive research method, the research process was as follows: a preliminary work list which was performed by New Nurse related to nursing management area was made of such key information as the domain of nursing management work, the element of that domain, and the detail work content, by means of a broad review of literature related to nursing management on Licensing Examination for the new nurse. After this preliminary work list sought to obtain examination, consensus, and modification of expert group in the nursing management field, research instrument which was the work list performed by new nurse within nursing management area was to developed. And next, it was to survey various of the importance and the frequency of that work performance by registered nurse, nurse manager, and the professors to take responsible of nursing management. Finally, the educational content for nursing management at the level of baccalaureate was proposed by various analyzing of research results. Results : The work list which was performed by new nurse related to nursing management area consisted of 9 domains, 24 elements, and 80 detail work contents. After it was examined into such various analysis as descriptive statistics, ANOVA, mean range, and so on, of the importance perception of the work and the frequency of work performance, the educational contents for baccalaureate in nursing management which consisted of total 65 contents made up of 18 core contents and 47 essential contents, which new nurses have to necessarily know and perform within the nursing management area. Conclusion : The results of this study will contribute to identifying the work list of new nurses performed in nursing management area and also proposing the educational contents that was taught at the level of baccalaureate in nursing management area based on doing actually in nursing unit.

• Molecules and Cells
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• v.43 no.6
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• pp.572-580
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• 2020

Transient receptor potential ankyrin 1 from rattlesnakes (rsTRPA1) and boas (bTRPA1) was previously proposed to underlie thermo-sensitive infrared sensing based on transcript enrichment in infrared-sensing neurons and hyper-thermosensitivity expressed in Xenopus oocytes. It is unknown how these TRPA1s show thermosensitivities that overwhelm other thermoreceptors, and why rsTRPA1 is more thermosensitive than bTRPA1. Here, we show that snake TRPA1s differentially require Ca²⁺ for hyper-thermosensitivity and that predisposition to cytosolic Ca²⁺ potentiation correlates with superior thermosensitivity. Extracellularly applied Ca²⁺ upshifted the temperature coefficients (Q10s) of both TRPA1s, for which rsTRPA1, but not bTRPA1, requires cytosolic Ca²⁺. Intracellular Ca²⁺ chelation and substitutive mutations of the conserved cytosolic Ca²⁺-binding domain lowered rsTRPA1 thermosensitivity comparable to that of bTRPA1. Thapsigargin-evoked Ca²⁺ or calmodulin little affected rsTRPA1 activity or thermosensitivity, implying the importance of precise spatiotemporal action of Ca²⁺. Remarkably, a single rattlesnake-mimicking substitution in the conserved but presumably dormant cytosolic Ca²⁺-binding domain of bTRPA1 substantially enhanced thermosensitivity through cytosolic Ca²⁺ like rsTRPA1, indicating the capability of this single site in the determination of both cytosolic Ca²⁺ dependence and thermosensitivity. Collectively, these data suggest that Ca²⁺ is essential for the hyper-thermosensitivity of these TRPA1s, and cytosolic potentiation by permeating Ca²⁺ may contribute to the natural variation of infrared senses between rattlesnakes and boas.

• Korean Journal of Health Education and Promotion
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• v.30 no.4
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• pp.41-56
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• 2013

Objectives: This article reviewed researches on intersectoral partnership of school health programs to suggest importance, current status and development plan of those. Methods: Domestic research papers were screened though Research Information Sharing Service (RISS), Koreanstudies Information Service System (KISS), Medical Library Information System (MEDLIS), Korean Medical Database (KMbase), and digital national assembly library. International papers were searched mainly via Pubmed. Results: Since intersectoral partnership is effective, comprehensive and universal approach for school health programs, many collaborative programs are universally progressing in various domain including smoking, alcohol, mental health and sexual behavior. On the other hand, intersectoral partnership of school health programs in Korea is still in the beginning stage, and there are few intersectoral partnerships. Moreover, there are several limitations including top-down approach, passive participation and lack of studies on the effect of intersectoral partnership. However, intersectoral partnerships in school health program including tuberculosis control system in school or WEE project are in progress, so it is worth looking forward in the future. Conclusions: To achieve successful intersectoral partnership in school health programs, appropriate partnership guideline for Korean society, policy support, active participation and improvement of consciousness in community stakeholders are needed.

• Korean Medical Education Review
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• v.25 no.3
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• pp.212-228
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• 2023

Systems thinking, a linking domain of health systems science (HSS), is an approach that investigates specific problems from a holistic perspective. It supports improving patients' health, fulfilling their health needs, and anticipating issues that threaten patient safety within the healthcare system. It also helps solve problems through critical thinking and ref lection. This study aimed to develop an curriculum on systems thinking, explore the effectiveness of the course, and investigate the applicability of HSS education at individual universities. In this study, the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model was utilized to design, develop, implement, and evaluate an elective course on systems thinking. In the design process, learning outcomes and goals were developed, and educational content, teaching-learning methods, and student evaluation methods were linked. In the development process, class materials and evaluation materials were prepared. In the implementation process, the course was implemented, and the evaluation process analyzed the results of learning performance and curriculum assessments. The evaluation found the following results. First, the students in the study realized the importance of systems thinking and experienced the need for systems thinking through non-medical and medical situations. Second, the students were very satisfied with the learning activities in the course (mean=4.84), and the results of the self-competence evaluation, conducted before and after the course, also showed a significant improvement. This study confirmed the effectiveness of the elective course, and its results can serve as a reference for developing an HSS curriculum.

• Journal of the Korean Institute of Intelligent Systems
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• v.1 no.1
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• pp.9-25
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• 1991

This tutorial paper has been written for biologists, physicians or beginners in fuzzy sets theory and applications. This field is introduced in the framework of medical diagnosis problems. The paper describes and illustrates with practical examples, a general methodology of special interest in the processing of borderline cases, that allows a graded assignment of diagnoses to patients. A pattern of medical knowledge consists of a tableau with linguistic entries or of fuzzy propositions. Relationships between symptoms and diagnoses are interpreted as labels of fuzzy sets. It is shown how possibility measures (soft matching) can be used and combined to derive diagnoses after measurements on collected data. The concepts and methods are illustrated in a biomedical application on inflammatory protein variations. In the case of poor diagnostic classifications, it is introduced appropriate ponderations, acting on the characterizations of proteins, in order to decrease their relative influence. As a consequence, when pattern matching is achieved, the final ranking of inflammatory syndromes assigned to a given patient might change to better fit the actual classification. Defuzzification of results (i.e. diagnostic groups assigned to patients) is performed as a non fuzzy sets partition issued from a "separating power", and not as the center of gravity method commonly employed in fuzzy control. It is then introduced a model of fuzzy connectionist expert system, in which an artificial neural network is designed to build the knowledge base of an expert system, from training examples (this model can also be used for specifications of rules in fuzzy logic control). Two types of weights are associated with the connections: primary linguistic weights, interpreted as labels of fuzzy sets, and secondary numerical weights. Cell activation is computed through MIN-MAX fuzzy equations of the weights. Learning consists in finding the (numerical) weights and the network topology. This feed forward network is described and illustrated in the same biomedical domain as in the first part.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.3
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• pp.114-128
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• 2023

Objectives: This study was conducted to reflect Korean Medicine doctors (KMD)' perception of lifestyle management in the process of developing a Korean Medicine (KM) Clinical Practice Guidelines (CPG) of female infertility. Methods: We sent four e-mails containing links to online questionnaires to 25,286 KMD belonging to the Association of Korean Medicine. The questionnaire consisted of sexual intercourse, weight, diet, exercise, drinking, smoking, caffeine intake, stress etc. KMD responded to self-administered questionnaires, and we analyzed 786 responds. Results: KMD put stress first among the infertile women's lifestyle management items, weight and sexual intercourse were next. Also KMD put stress first among the spouses' lifestyle management items, drinking and sexual intercourse were next. In relation to sexual intercourse, 'Recognizing the Fertile Window' was the most important. In relation to stress in the emotional domain, 'Depression' and 'Anxiety' were the most important, and in relation to stress in the relationship domain, 'Deteriorating of marital relationship' was the most important. Conclusions: We surveyed the status of KMD' awareness of infertility lifestyle management for patient education, and reflected it in the modification of the CPG for female infertility.

• Animal cells and systems
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• v.2 no.2
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• pp.153-164
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• 1998

Cytokines regulate proliferation, differentiation and functions of haemotopoietic cells. Each cytokine possesses a variety of activities on various target cells (pleiotropy) and various cytokines have similar and overlapping activities on the same target cells (redundancy). The nature of these cytokine activities predicts unique feature of cytokine receptors, namely, cytokine has multiple receptors, different cytokines share a common receptor, and different cytokine receptors are linked to common signaling pathways. cDNA cloning of genes for cytokine receptors revealed distinct sets of receptor family with different structural features. The cytokine receptor superfamily consists of a largest family, and contains more than twenty cytokine receptor subunits. This receptor has common structural features in both extracellular and intracellular regions without tyrosine kinase domain. Another striking feature of the receptor is to share common subunit of multiple cytokines, which partly explains the redundancy of activities of some cytokines. Recent studies revealed detailed signaling events of the cytokine receptor, the primary activation of JAK and subsequent phosphorylation of tyrosine residues of receptor, and various cellular proteins. Many SH2 containing adapter proteins play an important role in cytokine signals, and this system has similarities with tyrosine kinase receptor signal transduction. STAT may mainly account for cytokine specific functions as suggested by knockout mice studies. It is of importance to note that cytokine activates multiple signaling pathways and the balance and combination of related signaling events may determine the specificity of functions of cytokines.