• Title/Summary/Keyword: Prospective approach

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Alveolar ridge preservation with an open-healing approach using single-layer or double-layer coverage with collagen membranes

  • Choi, Ho-Keun;Cho, Hag-Yeon;Lee, Sung-Jo;Cho, In-Woo;Shin, Hyun-Seung;Koo, Ki-Tae;Lim, Hyun-Chang;Park, Jung-Chul
    • Journal of Periodontal and Implant Science
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    • v.47 no.6
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    • pp.372-380
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    • 2017
  • Purpose: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. Methods: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. Results: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were $-1.7{\pm}0.5mm$ in the SL group and $-1.8{\pm}0.4mm$ in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. Conclusions: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.

A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

Supporting Market Entry Decisions For Global Expansion Using Option +Scenario Planning Analysis (실물옵션 및 시나리오 분석을 활용한 해외 건설시장 진출 의사결정 지원모델의 개발)

  • Kim, Byung-Il;Kim, Du-Yon;Han, Seung-Heon
    • Korean Journal of Construction Engineering and Management
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    • v.10 no.5
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    • pp.135-147
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    • 2009
  • The world has witnessed the dramatic expansion of international construction markets during the last decades, particularly around the developing economies and energy resource-rich countries. However, despite the booming markets, the risks of emerging regions have also increased under the rapidly changing environments confronting the global contractors. Most of all, success in overseas business mainly depends on selecting the right market to enter. Accordingly, the right market selection requires global firms to carefully carry out the scientific market entry decision by evaluating country risks, market prospects, firm's capability, level of competition, and among others. This study aims at developing a market entry model by the use of real option analysis (ROA) and scenario planning, which addresses the corporate strategic flexibility against the uncertainties encompassing the overseas construction markets. Based on the suggested approach, global contractors are expected to make a better decision rather than a typically static approach in pursuing, postponing, or abandoning a prospective market to their capacity with a concurrent consideration of uncertainties as well as its option value.

Role of Dedicated Subspecialized Radiologists in Multidisciplinary Team Discussions on Lower Gastrointestinal Tract Cancers

  • Sun Kyung Jeon;Se Hyung Kim;Cheong-il Shin;Jeongin Yoo;Kyu Joo Park;Seung-Bum Ryoo;Ji Won Park;Tae-You Kim;Sae-Won Han;Dae-Won Lee;Eui Kyu Chie;Hyun-Cheol Kang
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.732-741
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    • 2022
  • Objective: To determine the impact of dedicated subspecialized radiologists in multidisciplinary team (MDT) discussions on the management of lower gastrointestinal (GI) tract malignancies. Materials and Methods: We retrospectively analyzed the data of 244 patients (mean age ± standard deviation, 61.7 ± 11.9 years) referred to MDT discussions 249 times (i.e., 249 cases, as five patients were discussed twice for different issues) for lower GI tract malignancy including colorectal cancer, small bowel cancer, GI stromal tumor, and GI neuroendocrine tumor between April 2018 and June 2021 in a prospective database. Before the MDT discussions, dedicated GI radiologists reviewed all imaging studies again besides routine clinical reading. The referring clinician's initial diagnosis, initial treatment plan, change in radiologic interpretation compared with the initial radiology report, and the MDT's consensus recommendations for treatment were collected and compared. Factors associated with changes in treatment plans and the implementation of MDT decisions were analyzed. Results: Of the 249 cases, radiologic interpretation was changed in 73 cases (29.3%) after a review by dedicated GI radiologists, with 78.1% (57/73) resulting in changes in the treatment plan. The treatment plan was changed in 92 cases (36.9%), and the rate of change in the treatment plan was significantly higher in cases with changes in radiologic interpretation than in those without (78.1% [57/73] vs. 19.9% [35/176], p < 0.001). Follow-up records of patients showed that 91.2% (227/249) of MDT recommendations for treatment were implemented. Multiple logistic regression analysis revealed that the nonsurgical approach (vs. surgical approach) decided through MDT discussion was a significant factor for patients being managed differently than the MDT recommendations (odds ratio, 4.48; p = 0.017). Conclusion: MDT discussion involving additional review of radiology examinations by dedicated GI radiologists resulted in a change in the treatment plan in 36.9% of cases. Changes in treatment plans were significantly associated with changes in radiologic interpretation.

Connection of Dongmu Lee Je-ma's Sa-Sang Theory & Ken Wilber's all-quadrant approach (동무 이제마의 사상설(四象說)과 캔 윌버의 사상한(四象限) 일고(一考))

  • Heo, Hoon
    • Journal of Korean Philosophical Society
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    • v.116
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    • pp.411-435
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    • 2010
  • Ken Wilber(1949~) tries to approach integration of philosophy, emphasising the advent of the perennial philosophy in the exchange of scholarships at the present day. He suggests All Quadrant(四象限) for the first step to reach his integrated approach. In addition, his approach concretizes for AQAL(All Quadrant, All Level). His AQAL approach which can be divide into inside/outside, singular/plural, or interobjectivity/intersubjectivity is applied to a lot of fileds such as ecology, management, criminology, medical treatment and its boundary is getting bigger. The merits of Quadrant is that it can solve the problem of the plain(平原), which resolves the strength of subjective interior(cultural contexts) into the external existence(social system). From view of Dongmu Lee Je-ma(1837~1900), a former philosopher, Sa-Sang theory['Affairs-Mind-body-Objects(事心身物)', 'Heaven-Human-nature-Order(天人性命)] is in accord with Wilber in content. In Dongmu's writing, Quadrant(Affairs-Mind-body-Objects') called Sa-Sang theory(四象學) or Sasang Constitional Medicine(四象醫學) is basic component in order to explain the structure of all nature. 'Heaven-Human-nature-Order'; That is, 'Affairs-Mind-body-Objects' results in 'Heaven-Human-nature-Order' focused on human being(human body) in the universe. In other words, Sa-Sang theory is the same as the Wilver's inclusive perspectives from the universe and human being. Dongmu's Sa-Sang theory is compared with C. G. Jung(1875~1961)'s psychology and it helps both fields confirm the foundation and extend the province of application. Comparision of Dongmu's Quadrant with Wilber's is not just analogical reasoning. In comparison, Dongmu's Sa-Sang theory is more delicated and crystallized than Wilber's in medical prospective. Dongmu regards Quadrant not as diseases, but as origin of Physiology and Pathology. And he explains all of their courses as Quadrant.

Sputum Smear Conversion During mDOT (Modified Directly Observed Treatment) (변형된 복약확인 치료(mDOT) 수행 후의 균음전율에 대한 연구 부제: 보건소 균양성 폐결핵 환자를 대상으로)

  • Hwang, Taik Gun;Kim, Soon Deok;Yoo, Se Hwa;Shin, Yoo Chul
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.485-494
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    • 2004
  • Background : To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October $8^{th}$ 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. Methods : This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October $8^{th}$ 2001 and April $23^{rd}$ 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasiexperimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. Results : At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). Conclusions : The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.

Response Modeling for the Marketing Promotion with Weighted Case Based Reasoning Under Imbalanced Data Distribution (불균형 데이터 환경에서 변수가중치를 적용한 사례기반추론 기반의 고객반응 예측)

  • Kim, Eunmi;Hong, Taeho
    • Journal of Intelligence and Information Systems
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    • v.21 no.1
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    • pp.29-45
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    • 2015
  • Response modeling is a well-known research issue for those who have tried to get more superior performance in the capability of predicting the customers' response for the marketing promotion. The response model for customers would reduce the marketing cost by identifying prospective customers from very large customer database and predicting the purchasing intention of the selected customers while the promotion which is derived from an undifferentiated marketing strategy results in unnecessary cost. In addition, the big data environment has accelerated developing the response model with data mining techniques such as CBR, neural networks and support vector machines. And CBR is one of the most major tools in business because it is known as simple and robust to apply to the response model. However, CBR is an attractive data mining technique for data mining applications in business even though it hasn't shown high performance compared to other machine learning techniques. Thus many studies have tried to improve CBR and utilized in business data mining with the enhanced algorithms or the support of other techniques such as genetic algorithm, decision tree and AHP (Analytic Process Hierarchy). Ahn and Kim(2008) utilized logit, neural networks, CBR to predict that which customers would purchase the items promoted by marketing department and tried to optimized the number of k for k-nearest neighbor with genetic algorithm for the purpose of improving the performance of the integrated model. Hong and Park(2009) noted that the integrated approach with CBR for logit, neural networks, and Support Vector Machine (SVM) showed more improved prediction ability for response of customers to marketing promotion than each data mining models such as logit, neural networks, and SVM. This paper presented an approach to predict customers' response of marketing promotion with Case Based Reasoning. The proposed model was developed by applying different weights to each feature. We deployed logit model with a database including the promotion and the purchasing data of bath soap. After that, the coefficients were used to give different weights of CBR. We analyzed the performance of proposed weighted CBR based model compared to neural networks and pure CBR based model empirically and found that the proposed weighted CBR based model showed more superior performance than pure CBR model. Imbalanced data is a common problem to build data mining model to classify a class with real data such as bankruptcy prediction, intrusion detection, fraud detection, churn management, and response modeling. Imbalanced data means that the number of instance in one class is remarkably small or large compared to the number of instance in other classes. The classification model such as response modeling has a lot of trouble to recognize the pattern from data through learning because the model tends to ignore a small number of classes while classifying a large number of classes correctly. To resolve the problem caused from imbalanced data distribution, sampling method is one of the most representative approach. The sampling method could be categorized to under sampling and over sampling. However, CBR is not sensitive to data distribution because it doesn't learn from data unlike machine learning algorithm. In this study, we investigated the robustness of our proposed model while changing the ratio of response customers and nonresponse customers to the promotion program because the response customers for the suggested promotion is always a small part of nonresponse customers in the real world. We simulated the proposed model 100 times to validate the robustness with different ratio of response customers to response customers under the imbalanced data distribution. Finally, we found that our proposed CBR based model showed superior performance than compared models under the imbalanced data sets. Our study is expected to improve the performance of response model for the promotion program with CBR under imbalanced data distribution in the real world.

Solidification of Molten Salt Waste by Gel-Route Pre-treatment (겔화 전처리법을 이용한 폐용융염의 고형화)

  • Park Hwan Seo;Kim In Tae;Kim Hwan Young;Ryu Seung Kon;Kim Joon Hyung
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.3 no.1
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    • pp.57-65
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    • 2005
  • This study suggested a new method for the solidification of molten salt waste generated from the electro-metallurgical process in the spent fuel treatment. Using binary material system, sodium silicate and phosphoric acid, metal chlorides were converted into metal phosphate in the micro-reaction module formed by SiO$_{2} particles. The volatile element in the reaction module would little vaporized below 1100$^{circ}$C After the gel product was mixed with borosilicate glass powder and thermally treated at 1000$^{circ}$C, li exists as Li$_{3}$PO$_4$ separated from glass phase and, Cs and Sr would be incorporated into an amorphous phase from XRD analysis. In case of the addition of ZrCl$_{4}$ to the binary system, the gel products were transformed into NZP structure considered as an prospective ceramic waste form after heat-treatment above 700 $^{circ}$C. From these results, the gel-route pretreatment can be considered as an effective approach to the solidincation of molten salt waste by the confirmed process or waste form and this also would be an alternative method on the ANL method using zeolites in USA by the confirmation of its chemical durability as an future work.

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A Study on the Development of the Triple helix and University-Business incubation (트리플 힐릭스와 대학 창업보육의 발전방안)

  • Seol, Myung Hwan;Choi, Jong In
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.3
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    • pp.99-112
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    • 2018
  • This research focuses on the university-business incubation from the prospective of triple helix and summarizes complementary researches and develop plans for university-business incubation. To pursue these objectives, we analyzed the studies of triple helix on domestic as well as overseas university-business incubators and their collaboration. The findings of this study showed that firstly In order to innovate the business incubator of the university, it is necessary to secure sufficient competence for the capability. For this purpose, Research and policy implications from various perspectives must be preceded.. Second, the collaborative relationship of business incubations should lead to organic and dynamic cooperative relations instead of static cooperative partnerships. Furthermore, based on the internal innovation that runs the business incubation program together with bottom-up rather than top-down approach, it is necessary to plan incubation and lead the transformation through creative ideas. Third, for the dynamic collaboration of business incubation, the management and practice of the organization should be given priority so that the boundary spanning appropriate to each situation, which turn increase the absorption capacity. As a future direction, studies are expected to explore the development of innovative university-business incubation about boundary spanning and knowledge transformation.

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

  • Aghili, Mahdi;Sotoudeh, Sarvazad;Ghalehtaki, Reza;Babaei, Mohammad;Farazmand, Borna;Fazeli, Mohammad-Sadegh;Keshvari, Amir;Haddad, Peiman;Farhan, Farshid
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.17-24
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    • 2018
  • Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.