• KSII Transactions on Internet and Information Systems (TIIS)
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• v.18 no.9
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• pp.2589-2604
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• 2024

Brain tumors, characterized by uncontrollable cellular growths, are a significant global health challenge. Navigating the complexities of tumor identification due to their varied dimensions and positions, our research introduces enhanced methods for precise detection. Utilizing advanced learning techniques, we've improved early identification by preprocessing clinical dataset-derived images, augmenting them via a Generative Adversarial Network, and applying an Improved Privacy-Preserving Collaborative Convolutional Neural Network (IPC-CNN) for segmentation. Recognizing the critical importance of data security in today's digital era, our framework emphasizes the preservation of patient privacy. We evaluated the performance of our proposed model on the Figshare and BRATS 2018 datasets. By facilitating a collaborative model training environment across multiple healthcare institutions, we harness the power of distributed computing to securely aggregate model updates, ensuring individual data protection while leveraging collective expertise. Our IPC-CNN model achieved an accuracy of 99.40%, marking a notable advancement in brain tumor classification and offering invaluable insights for both the medical imaging and machine learning communities.

• Journal of Korean Clinical Nursing Research
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• v.30 no.2
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• pp.125-138
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• 2024

Purpose: This study aimed to assess the perception and performance of antimicrobial stewardship among clinical nurses and to contribute to establishing their role through an Importance-Performance Analysis(IPA) matrix. Methods: The study included 203 nurses working in hospitals of general hospital level or higher. Data collection took place from April 9 to May 6, 2024. Data analysis involved descriptive statistics, t-tests, ANOVA, Scheffé tests, and IPA analysis. Results: The average perception score for antimicrobial stewardship was 4.42±0.46, while the performance score was 3.96±0.53. Significant differences in perception and performance were observed across several ares: observation of patients, checking with/suggesting to physician based on assessments, implement tests and antimicrobial administration, patient education and support, coordinating multiple disciplines and institutions, acquiring up to date knowledge(p<.050). Perception was highest in the area of implement tests and antimicrobial administration but lowest in coordinating multiple disciplines and institutions. Conclusion: To establish the specific role of nurses in antimicrobial stewardship, improving nurse perception and fostering collaboration with various experts are essential. Developing educational programs and institutional support tailored to nurses is necessary to address areas identified for improvement in both perception and performance.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.143-149
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• 2012

Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.

• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.73-94
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• 2010

The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.170-181
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• 2011

Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.510-537
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• 1995

Human health is an integral part of experience in the process of Human Becoming. Through continual interaction with the environment human beings freely choose experience and develop as responsible beings. The process of the health experience of patient with terminal cancer is a unique. he objective of this study is to understand the lived experience of patients with terminal cancer in order to provide basic information for nursing care in the clinical setting and to develop a theoretical background for clinical practice. This study is to de-scribe and define the lived experience of patients with terminal cancer in order to provide a foundation for nursing research and education. Data collection has been done between December 1993 and November 1994. The subjects included five persons -four females and one male : one who was in her sixties, one in his fifties, two in their forties, and one who was in her thirties. The researcher has met with these patients 35 times, but at eight times the patient was in a stuporous condition and not able to participate, so these were not included in the data analysis. Parse's "Human Becoming Methodology", an existential phenomenological research methodology is used for this study. Data has been collected using he dialogical engagement process of "I and You", the participant researcher and the participant subject. Dialogical engagement was discontinued when the data was theoretically saturated. Data was analyzed using the extraction - synthesis and heuristic interpretation. The criteria of Guba and Lincoln(1985). and Sandelo wski(1986) : credibility, auditability, fitness and objectivity were used to test the validity and reliability of the data. The following is a description of the structure of the lived experience of patients with terminal cancer as defined by this study : 1. Structure : 1) Suffering through the reminiscence of past experience 2) The appearance of complex emotions related to life and connectedness 3) The increasing importance of significant people and of the Absolute Being 4) The increasing realization of the importance of health and belief 5) Desire for a return to health and a peaceful life or for acceptance of dying and a comfortable death In summary the structure of the lived experience of these patients can be said to be : suffering comes through reminiscence of past experience, and there are complex emotions related to life and connectedness. Significant people and the Absolute Being become increasingly important along with a realization of the importance of health and faith. And finally there is a desire for either a return to health and a peaceful life or for the acceptance of dying and a comfortable death. 2. Heuristic Interpretation : Using Parse's Human Becoming Methodology, the structure of the lived experience of patients with terminal cancer identified in this research is interpreted as. The lived experience of patients with terminal cancer involves the solving of past conflicts, and the experience of the healing and valuing of sorrow and pain. Through the relation of life and health, and the complex emotions that arise, the lived experience of revealing - concealing is of paradoxical emotions. The increasing importance of significant others and of the Absolute Being shows Connecting and Separating an on- going process of nearness and farness. Revision of thoughts about health and faith is interpreted as transforming and desire for restoration to health and a peaceful life or acceptance of dying and a cowfortable death, as powering. In summary, it is possible to see, in the lived experience of patients with terminal cancer, the relationship of the five concepts of Parse's theory : valuing, revealing -concealing, connecting-separating, transforming, and powering. From Parse's theory, the results of this study show that meaning is related to valuing, rhythmicity to revealing-concealing and connect-ing-separating, and cotranscendence to transforming and powering.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.203-217
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• 2021

Purpose: The purpose of this meta-analysis was to examine the high-level evidence of the effects of manual therapy on musculoskeletal diseases. Methods: Domestic databases were searched for studies that conducted clinical trials associated with manual therapy on chronic musculoskeletal diseases. A total of 591 studies published between 2005 and 2018 were identified, with 18 studies satisfying the inclusion data. The studies were classified according to patient, intervention, comparison, and outcome (PICO). The search outcomes were items associated with pain and physical function. The 18 studies included in the study were evaluated by using the R meta-analysis (version 4.0). The quality of 18 randomized control trials was evaluated by using the Cochrane risk of bias (ROB). The effect sizes were computed as the corrected standardized mean difference (SMD). Subgroup and meta-regression analyses were also used. Egger's regression test was carried out in order to analyze the publication bias. Cumulative meta-analysis and sensitivity analysis were also conducted in order to analyze the data error. Results: The following factors showed the large effect size of manual therapy on chronic musculoskeletal diseases: pain (Hedges's g = 2.66; 95% CI = 1.47 ~ 3.85), and physical function (Hedges's g = 2.15; 95% CI: 1.22 ~ 3.08). The subgroup analysis only showed a statistical difference in the type of manual therapy (pain) and outcome (physical function). No statistically significant difference was found in the meta-regression analysis. Publication bias was found in the data, but the results of the trim-and-fill method showed that such bias did not largely affect the obtained data. Furthermore, there were no data errors in the cumulative meta-analysis and sensitivity analysis. Conclusion: This study provides evidence for the effectiveness of manual therapy on chronic musculoskeletal diseases in pain and physical function. Subgroup analysis suggests that only the type of manual therapy for pain and the type of outcome for physical function differed in effect size.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.280-291
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• 2011

Vaccines are products for immunization which can provoke antibodies by eliciting immune reponses without causing disease and have played an important role in preventing fatal and contagious diseases as well as H1N1 influenza. They are classified by two following categories; lived attenuated vaccine and killed vaccine and currently commonly using vaccines are BCG, diphtheria, tetanus, mumps, measles, rubella, polio, Haemophilus influenza type b, hepatitis B, influenza etc. All vaccines must be used correctly to reach optimal therapeutic goals and also informed well to patients to decrease potential problems. In order to do, pharmacists must have good knowledge of vaccines. The purpose of this study is to evaluate the necessity of vaccine education for pharmacists and develop a vaccine leaflet for patient counseling. We have performed a survey with questionnaire for a total of 176 pharmacists and nurses(hospital pharmacists, n=65; community pharmacists, n=50; hospital nurses, n=61) from January 27th to March 12th, 2010. The questionnaire includes items about vaccine education and counseling and 12 quizzes to evaluate responders' knowledge of vaccines. We used the SPSS(Version 12. for windows) program to analyze the data. In results, 94.9% of all responders said they had not been educated on vaccines. And only 1.1% of all responders said they know about vaccines enough to counsel patients. Pharmacists who have an experience recommending vaccines to other people are 21.7%. On the other hand, nurses who have an experience recommending vaccines to other people are 55.7%(p=0.000). The mean number of correct answers at the 12 quizzes are followings; hospital pharmacist, 8.1; community pharmacist, 6.1, hospital nurses, 6.2(p=0.000). A vaccine leaflet for patient counseling is developed with several references. In conclusion, due to no opportunity of vaccine education, pharmacists have no confidence to counsel patients and lack of knowledge of vaccine. But importance of vaccine's role is increasing, pharmacists should counsel patients in vaccination. So they need vaccine education and a vaccine leaflet will be helpful for their counseling.

• Journal of Music and Human Behavior
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• v.14 no.1
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• pp.17-39
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• 2017

This study aimed to review Korean-written and English-written studies on music interventions for family caregivers of patients in medical settings. Electronic databases were searched for studies published through 2016, using the keywords of music intervention, family caregivers, and specified settings. A total of 43 studies, five Korean-written and 38 English-written studies, were selected. The results showed that caregivers were the sole participants in five studies (family-only), and caregivers and patients co-participated in 38 studies (family-patient). While diversified types of family participation were included in the English-written studies dating back to the late 1980s, the Korean-written studies were the only ones to include patients as co-participants with their caregivers. Studies with family-only participation tended to be conducted in palliative care units and usually included the spouses of the patients. Meanwhile, studies with family-patient participation tended to be conducted in NICU or cancer units and usually included the parents of the patients. Furthermore, studies with family-only participation tended to apply passive music activities, and those with family-patient participation tended to use active music activities. The results of this study present baseline data on how family-centered care can be included in music interventions in medical settings in Korea, suggesting future studies to systematically analyze music interventions for family caregivers in terms of diversified patient- and caregiver-related factors.

• Progress in Medical Physics
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• v.21 no.1
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• pp.60-69
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• 2010

For treatment of Total Skin Electron beam Therapy (TSET), measurement of dose at various conditions is need on the contrary to usual radiotherapy. When treating TSET with modified Stanford technique based on linear accelerator, the energy of treatment electron beam, the spatial dose distribution and the actual doses deposited on the surface of the patient were measured by using EBT2. The measured energy of the electron beam was agreed with the value that measured by ionization chamber, and the spatial dose distribution at the patient position and the doses at several point on the patient's skin could be easily measured by EBT2 film. The dose on the patient that was measured by EBT2 film showed good agreement with the data measured simultaneously by TLD. With the results of this study, it was proven that the EBT2 film can be one of the useful dosimeter for TSET.