• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.111-121
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• 2020

Purpose: The purpose of this study was to compare visual blood loss estimation and subjective emergency according to clothing color. Methods: This is a quasi-experimental study which involved the use of mock bleeding patients wearing different colors tops. Results: Differences in visual estimates according to clothing color were significant in both paramedic students (F=6.69, p=.002) and the general department students (F=20.92, p=.000). When looking specifically at the accuracy of visual estimates, the paramedic students group tended to underestimate (50% white, 62.5% black, 32.5% yellow) the actual blood volume in all experimental conditions. On the other hand, the general department group tended to overestimation (45% white, 40% black, 67.5% yellow). The subjective emergency was also found to differ between paramedic students (F=13.58, p=.000) and general department students (F=9.67, p=.000). Conclusion: Paramedics treating bleeding patients at pre-hospital stages need to pay attention to blood loss estimations depending on clothing color, a factor not to be neglected or underestimated.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.3
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• pp.392-400
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• 2011

Purpose: This study was done to provide fundamental data to develop a simulation application working practice module and to develop a strategy that would improve team efficacy of students, as well as interpersonal understanding, and proactivity in problem solving after using the team based learning simulation. Methods: The participants were students in fourth year in C University and they participated in the simulation learning for 8 weeks from October to December 2010. The variables of team efficacy, interpersonal understanding, and proactivity in problem solving were measured and data were analyzed using SPSS WIN 17.0 program. Results: After applying the team based simulation learning, students' team efficacy, interpersonal understanding, and proactivity in problem solving improved significantly. Conclusion: The results indicate that the simulation module in this study gave the students experience in providing available and safe nursing care under conditions similar to reality and also underlined the importance of team competency for student nurses in caring for patients.

• Nuclear Engineering and Technology
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• v.54 no.9
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• pp.3422-3428
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• 2022

The prompt gamma imaging (PGI) technique is considered as one of the most promising approaches to estimate the range of proton beam in the patient and unlock the full potential of proton therapy. In the PGI technique, a dedicated algorithm is required to estimate the range of the proton beam from the prompt gamma (PG) distribution acquired by a PGI system. In the present study, a new range estimation algorithm was developed for a multi-slit prompt-gamma camera, one of PGI systems, to estimate the range of proton beam with high accuracy. The performance of the developed algorithm was evaluated by Monte Carlo simulations for various beam/phantom combinations. Our results generally show that the developed algorithm is very robust, showing very high accuracy and precision for all the cases considered in the present study. The range estimation accuracy of the developed algorithm was 0.5-1.7 mm, which is approximately 1% of beam range, for 1×10⁹ protons. Even for the typical number of protons for a spot (1×10⁸), the range estimation accuracy of the developed algorithm was 2.1-4.6 mm and smaller than the range uncertainties and typical safety margin, while that of the existing algorithm was 2.5-9.6 mm.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.2
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• pp.64-74
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• 2022

Digital dentistry is becoming a mainstream of dental practice. We are already used to intraoral scan, guided implant surgery, manufacture of prosthesis (CAD-CAM) in our daily practice; those are not sensational anymore. However, treatment planning with digital simulations is not spotlighted enough. In this report, a digital mockup was utilized to visualize the final goal of maxillary rehabilitation including all anterior and posterior teeth, and persuade a patient who wanted restoration of only anterior teeth. We will also discuss the use of digital mockup and its actual copy as the guide of altered vertical dimension through the clinical process.

• Journal of the Korean Applied Science and Technology
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• v.40 no.6
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• pp.1413-1424
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• 2023

Virtual reality (VR) simulation in nursing education, especially in the teaching of VR simulations just prior to clinical practice, has the potential to enhance the effectiveness of clinical practice and better prepare nursing students for patient care. The aim of this study was to evaluate the effect of a preclinical VR simulation education program on the development of critical thinking, self-efficacy, problem-solving ability, and perceived clinical competency among undergraduate nursing students. The study was conducted between May and June 2021 using a pretest-posttest design with a control group. A total of 42 nursing students were recruited through convenience sampling from two separate classes. The intervention group participated in VR simulation education, while the control group engaged in lecture-based education, before beginning clinical practice. Assessments were conducted before preclinical education and after completing clinical practice using structured questionnaires. The data was analyzed using chi-square tests, independent t-tests, and ANCOVA. The findings indicated that the intervention group had a significantly higher score in perceived clinical competency compared to the control group (F = 5.25, p = 0.029) after controlling for pretest scores. However, there were no statistically significant differences in critical thinking, self-efficacy, or problem-solving abilities between the two groups. These findings suggest that preclinical VR simulation education is partially effective in preparing nursing students for their clinical practice, underscoring the need for a balanced educational approach that integrates VR with clinical practice to develop a full spectrum of nursing skills and knowledge.

• Progress in Medical Physics
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• v.23 no.2
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• pp.81-90
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• 2012

The effect of setup uncertainties on CTV dose and the correlation between setup uncertainties and setup margin were evaluated by Monte Carlo based numerical simulation. Patient specific information of IMRT treatment plan for rectal cancer designed on the VARIAN Eclipse planning system was utilized for the Monte Carlo simulation program including the planned dose distribution and tumor volume information of a rectal cancer patient. The simulation program was developed for the purpose of the study on Linux environment using open source packages, GNU C++ and ROOT data analysis framework. All misalignments of patient setup were assumed to follow the central limit theorem. Thus systematic and random errors were generated according to the gaussian statistics with a given standard deviation as simulation input parameter. After the setup error simulations, the change of dose in CTV volume was analyzed with the simulation result. In order to verify the conventional margin recipe, the correlation between setup error and setup margin was compared with the margin formula developed on three dimensional conformal radiation therapy. The simulation was performed total 2,000 times for each simulation input of systematic and random errors independently. The size of standard deviation for generating patient setup errors was changed from 1 mm to 10 mm with 1 mm step. In case for the systematic error the minimum dose on CTV $D_{min}^{stat{\cdot}}$ was decreased from 100.4 to 72.50% and the mean dose $\bar{D}_{syst{\cdot}}$ was decreased from 100.45% to 97.88%. However the standard deviation of dose distribution in CTV volume was increased from 0.02% to 3.33%. The effect of random error gave the same result of a reduction of mean and minimum dose to CTV volume. It was found that the minimum dose on CTV volume $D_{min}^{rand{\cdot}}$ was reduced from 100.45% to 94.80% and the mean dose to CTV $\bar{D}_{rand{\cdot}}$ was decreased from 100.46% to 97.87%. Like systematic error, the standard deviation of CTV dose ${\Delta}D_{rand}$ was increased from 0.01% to 0.63%. After calculating a size of margin for each systematic and random error the "population ratio" was introduced and applied to verify margin recipe. It was found that the conventional margin formula satisfy margin object on IMRT treatment for rectal cancer. It is considered that the developed Monte-carlo based simulation program might be useful to study for patient setup error and dose coverage in CTV volume due to variations of margin size and setup error.

• Progress in Medical Physics
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• v.23 no.3
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• pp.162-168
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• 2012

In proton therapy, in vivo dose verification is one of the most important parts to fully utilize characteristics of proton dose distribution concentrating high dose with steep gradient and guarantee the patient safety. Currently, in order to image the proton dose distribution, a prompt gamma distribution detection system, which consists of an array of multiple CsI(Tl) scintillation detectors in the vertical direction, a collimator, and a multi-channel DAQ system is under development. In the present study, the optimal design of prompt gamma distribution detection system was studied by Monte Carlo simulations using the MCNPX code. For effective measurement of high-energy prompt gammas with enough imaging resolution, the dimensions of the CsI(Tl) scintillator was determined to be $6{\times}6{\times}50mm^3$. In order to maximize the detection efficiency for prompt gammas while minimizing the contribution of background gammas generated by neutron captures, the hole size and the length of the collimator were optimized as $6{\times}6mm^2$ and 150 mm, respectively. Finally, the performance of the detection system optimized in the present study was predicted by Monte Carlo simulations for a 150 MeV proton beam. Our result shows that the detection system in the optimal dimensions can effectively measure the 2D prompt gamma distribution and determine the beam range within 1 mm errors for 150 MeV proton beam.

• Communications for Statistical Applications and Methods
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• v.18 no.5
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• pp.581-594
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• 2011

The traditional method of 3+3 standard design and model-based Bayesian continual reassessment method (CRM) are commonly used in Phase I clinical trials to identify the maximal tolerated dose(MTD) of a new drug. In this paper we review clinical examples of Phase I trials that were carried out in patients with refractory or relapsed leukemia and myelodysplastic syndrome. The recently proposed 3+1+1 design and rolling-6 design can shorten the trial duration, when a very slow accrual of patients with a simple 3+3 standard design may result in the untimely termination of trials. Too conservative approaches in determining the dose levels in Phase I clinical trials can leave clinical investigators unable to accurately determine the MTD. When determining future patient doses, the designs that use a time-to-event CRM can cooperate late toxicities by accounting for the proportion of the observation period of each enrolled patient. With the CRM design, simulations under different scenarios during the trial are important in detecting the under- or over-estimation of the initial estimate of the dose-limiting toxicity rate for each dose level. We present the advantages and drawbacks of the designs used in Phase I clinical trials for leukemia patients.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.51-60
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• 2010

Purpose: The purpose of this study was to compare the effects of nursing simulations between multi-mode simulation and $SimMan^{(R)}$ simulation on nursing students' nursing competency, satisfaction, and simulation participation experience in nursing care for patients with dyspnea. Method: Subjects were 107 junior nursing students in R College of Nursing in Seoul from June to November in 2009. Students were allocated to either a Multi-mode simulation group or a $SimMan^{(R)}$ simulation group. The multi-mode simulation consisted of standardized patients combined with Vital Sim, comparing the $SimMan^{(R)}$ group. Result: The Multi-mode simulation group reported higher levels of nursing competency (p=.017) but lower communication skills (p<.001) compared to the $SimMan^{(R)}$ simulation group. There were no meaningful differences in satisfaction of simulation education between the two groups. The $SimMan^{(R)}$ simulation group received a substantial health assessment and the Multi-mode simulation group experienced reality in caring for standardized patients. Conclusion: The findings of this study demonstrated that Multi-mode simulation has similar educational effects like $SimMan^{(R)}$ simulation and suggest that nurse educators should match simulation fidelity with educational goals for effective education.

• Proceeding of EDISON Challenge
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• 2015.03a
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• pp.14-23
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• 2015

Alzheimer's disease is one of the most common types of degenerative dementia. As a considerable cause of Alzheimer's disease, neurotoxic plaques composed of 39 to 42 residue-long amyloid beta($A{\beta}$) fibrils have been found in the patient's brain in large quantity. A previous study found that erythrosine B (ER), a red color food dye approved by FDA, inhibits the formation of amyloid beta fibril structures. Here, in an attempt to elucidate the inhibition mechanism, we performed molecular dynamics simulations to demonstrate the conformational change of $A{\beta}40$ induced by 2 ERs in atomistic detail. During the simulation, the ERs bound to the surfaces of both N-terminus and C-terminus regions of $A{\beta}40$ rapidly. The observed stacking of the ERs and the aromatic side chains near the N-terminus region suggests a possible inhibition mechanism in which disturbing the inter-chain stacking of PHEs destabilizes beta-sheet enriched in amyloid beta fibrils. The bound ERs block water molecules and thereby help stabilizing alpha helical structure at the main chain of C-terminus and interrupt the formation of the salt-bridge ASP23-LYS28 at the same time. Our findings can help better understanding of the current and upcoming treatment studies for Alzheimer's disease by suggesting inhibition mechanism of ER on the conformational transition of $A{\beta}40$ at the molecular level.