• Title/Summary/Keyword: Risk importance

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Exploring the variations of the pancreatic ductal system: a systematic review and meta-analysis of observational studies

  • Adil Asghar;Ravi Kant Narayan;Nagavalli Basavanna Pushpa;Apurba Patra;Kumar Satish Ravi;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.57 no.1
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    • pp.31-44
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    • 2024
  • The exocrine part of the pancreas has a duct system called the pancreatic ductal system (PDS). Its mechanism of development is complex, and any reorganization during early embryogenesis can give rise to anatomical variants. The aim of this study is to collect, classify, and analyze published evidence on the importance of anatomical variants of the PDS, addressing gaps in our understanding of such variations. The MEDLINE, Web of Science, Embase, and Google Scholar databases were searched to identify publications relevant to this review. R studio with meta-package was used for data extraction, risk of bias estimation, and statistical analysis. A total of 64 studies out of 1,778 proved suitable for this review and metanalysis. The meta-analysis computed the prevalence of normal variants of the PDS (92% of 10,514 subjects). Type 3 variants and "descending" subtypes of the main pancreatic duct (MPD) predominated in the pooled samples. The mean lengths of the MPD and accessory pancreatic duct (APD) were 16.53 cm and 3.36 cm, respectively. The mean diameters of the MPD at the head and the APD were 3.43 mm and 1.69 mm, respectively. The APD was present in only 41% of samples, and the long type predominated. The pancreatic ductal anatomy is highly variable, and the incorrect identification of variants may be challenging for surgeons during ductal anastomosis with gut, failure to which may often cause ductal obstruction or pseudocysts formation.

A Study on Improvement Measures for Internal Controls in Cryptocurrency (가상자산 운영의 위험관리를 위한 내부통제 개선방안에 관한 연구)

  • Byoung Hoon Choi;JinYong Lee;Sam Hyun Chun
    • Convergence Security Journal
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    • v.24 no.3
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    • pp.51-57
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    • 2024
  • Cryptocurrency service providers and virtual asset operators, built on blockchain technology, face transaction risks such as cyber threats, wallet theft by internal personnel, theft of customers' private keys, and fraudulent cryptocurrency transfer signatures. To ensure secure operations against these threats, their security is validated through the ISMS-P certification. This study to analyze the risks presented in ISO TR 23576, which is specialized for cryptocurrency service providers and operators, in addition to the ISMS-P certification they obtain. The study will focus on the detailed inspection items of ISMS-P and ISO TR 23576 for cryptocurrency service providers and assess their importance. Based on this analysis, the study proposes an internal security control process for cryptocurrency service providers to address the top-priority risks, enabling practitioners to perform security control tasks more efficiently.

Endovascular treatment for anterior inferior cerebellar artery-posterior inferior cerebellar artery (AICA-PICA) common trunk variant aneurysms: Technical note and literature review

  • Jerry C. Ku;Vishal Chavda;Paolo Palmisciano;Christopher R. Pasarikovski;Victor X.D. Yang;Ruba Kiwan;Stefano M. Priola;Bipin Chaurasia
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.452-461
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    • 2023
  • The Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) common trunk is a rare variant of cerebral posterior circulation in which a single vessel originating from either the basilar or vertebral arteries supplies both cerebellum and brainstem territories. We present the first case of an unruptured right AICA-PICA aneurysm treated with flow diversion using a Shield-enhanced pipeline endovascular device (PED, VANTAGE Embolization Device with Shield Technology, Medtronic, Canada). We expand on this anatomic variant and review the relevant literature. A 39-year-old man presented to our treatment center with vertigo and right hypoacusis. The initial head CT/CTA was negative, but a 4-month follow-up MRI revealed a 9 mm fusiform dissecting aneurysm of the right AICA. The patient underwent a repeat head CTA and cerebral angiogram, which demonstrated the presence of an aneurysm on the proximal portion of an AICA-PICA anatomical variant. This was treated with an endovascular approach that included flow diversion via a PED equipped with Shield Technology. The patient's post-procedure period was uneventful, and he was discharged home after two days with an intact neurological status. The patient is still asymptomatic after a 7-month follow-up, with MR angiogram evidence of stable aneurysm obliteration and no ischemic lesions. Aneurysms of the AICA-PICA common trunk variants have a high morbidity risk due to the importance and extent of the territory vascularized by a single vessel. Endovascular treatment with flow diversion proved to be both safe and effective in obliterating unruptured cases.

Prevalence and molecular characteristics of carbapenem-resistant Escherichia coli isolated from dogs in South Korea

  • Bo-Youn Moon;Md. Sekendar Ali;Seunghoe Kim;Hee-Seung Kang;Ye-Ji Kang;Jae-Myung Kim;Dong-Chan Moon;Suk-Kyung Lim
    • Journal of Veterinary Science
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    • v.25 no.5
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    • pp.67.1-67.8
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    • 2024
  • Importance: Carbapenem-resistant Enterobacteriaceae are emerging as a global public health risk. Therefore, assessing the prevalence of carbapenem-resistant Escherichia coli (CRE) in both humans and animals is important. Objective: We aimed to ascertain the occurrence and characteristics of CRE isolated from companion animals, dogs and cats. Methods: E. coli strains were tested for antimicrobial susceptibility using the broth microdilution technique. Antimicrobial resistance genes were detected by polymerase chain reaction and sequencing analysis. The molecular characteristics of CRE were determined using multi-locus sequence typing, replicon typing, and pulsed-field gel electrophoresis (PFGE). Results: In total, 13 CRE isolates (0.13%) were identified from dogs possessing blaNDM-5 along with β-lactamase genes, mostly blaCMY-2 (92.2%) and blaTEM-1 (53.8%). The commonly observed mutations were S83L and D87N in gyrA, S80I in parC, and S458A in parE. CRE carried non-beta-lactam resistance genes, with the majority being tet(B) (100%), sul (84.6%), and aac(3)-II (53.8%). Nine different PFGE patterns (P1-P9), IncX3-type plasmids (69.2%), and ST410 (84.6%) were predominantly detected. Conclusions and Relevance: This investigation provides significant insight into the prevalence and molecular characteristics of blaNDM-5-carrying E. coli in dogs. The co-existence of blaNDM-5 and other antimicrobial resistance genes in E. coli potentially poses severe health hazards to humans.

The unseen spread: a case of disseminated tuberculosis with renal manifestation in a healthy adult

  • Miyeon Kim;Jeong Sub Lee;Jeong Rae Yoo
    • Journal of Medicine and Life Science
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    • v.21 no.3
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    • pp.121-126
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    • 2024
  • Disseminated tuberculosis (TB), resulting from the hematogenous spread of tubercle bacilli, typically affects immunocompromised individuals, such as those infected with the human immunodeficiency virus. However, risk factors in immunocompetent populations are not well understood. Here, we report a rare case of disseminated TB with CD4+ T-cell depletion in a previously healthy 35-year-old man. The patient presented with a 2-month history of intermittent gross hematuria, dysuria, loose stools, and weight loss. His medical history was unremarkable except for a herpes zoster infection 4 years prior to presentation. Laboratory tests revealed microscopic hematuria and pyuria; however, the urine culture was negative. Urine specimens tested positive for TB-polymerase chain reaction. Abdominal computed tomography revealed a focal filling defect in the left kidney, segmental wall thickening of the terminal ileum, and multiple enlarged lymph nodes with central necrosis. Chest computed tomography revealed active pulmonary TB. Colonoscopy confirmed intestinal TB in the terminal ileum and ileocecal valve, with positive TB-polymerase chain reaction results from sputum and ileal ulcer tissue. The patient was diagnosed with disseminated TB and was treated with standard anti-TB drugs. Although the human immunodeficiency virus test results were negative, the patient's CD4+ T-cell count was significantly low (278/μL). Follow-up tests after 1 month showed negative TB cultures; however, the patient's CD4+ T-cell depletion persisted, with counts remaining low after 1 year. This case highlights the rare occurrence of disseminated TB in immunocompetent individuals with CD4+ T-cell depletion and emphasizes the importance of CD4+ T-cell assessment in healthy patients presenting with disseminated TB.

Study on economic effects of outsourcing of food materials on the hotel kitchen - Focus on cooking Western food in the first class hotel - (식재료 아웃소싱이 경제적 주방에 미치는 영향에 관한 연구 - 특1급호텔 양식조리를 중심으로 -)

  • 성태종
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • v.13 no.2
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    • pp.45-69
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    • 2002
  • This study is designed to examine feasibility and limitation of outsourcing in cooking Western food in a hotel, to interpret importance of outsourcing(eg. outside order, outside procurement, outside supply) in a broad sense in order to reinforce the core capacity in the cooking department, and to know whether the cooking human power is efficiently used and how much the chefs recognize outsourcing of food materials. As many companies conduct restructuring to cut down its size, the reduction of human power led the Western food cooking in the hotel to lower core capacities, lower quality, and lower efficiency. In addition, the sagging morale of chefs undermined creativity. To change from the traditional kitchen to an economic kitchen needs to look into importance of outsourcing, cognitive attitude of chefs, relation with outside suppliers. Here suggests performance of positive changes in the structure The study examined feasibility and limitation of outsourcing in the hotel kitchen as well as chefs' cognitive attitude toward outsourcing of food materials to reinforce core capabilities of the hotel kitchen. 1. Companies of outsourcing are selected according to variability of price conditions, flexibility of contract conditions, popularity of the outsourcing company, and reputation of the outsourcing company. 2. The importance of outsourcing in the Western food cooking is divided into 4 factors such as standard of selecting outsourcing companies, policies of cooking manu, quality of cooking, and quantity of cooking. 3. The most feasible section in outsourcing of food materials is a process of kneading flour for bread, which shows that many Western-food chefs expect to put higher possibility of outsourcing on the kneading. In other words, when it comes to confectionery and bakery, there are many outside expert processing companies supplying high quality products. In the order of outsourcing feasibility, sauce is followed by processed vegetable, garnish of main dish, and soup. The least feasible section in outsourcing of food materials is appetize. Appetize includes a concept of a improvised dish and needs speed. Due to its color, freshness, and sensibility of taste, the appetize plays a key role in the Western food cooking. 4. When outsourcing is taken in place, the highest risk is to lower the inner cooking skills. Therefore chefs in charge of the Western food sequently recognize both internal problems including storage of cooking skills, unstability of layoffs, and loss of cooperation between departments, and external problems including inferior goods, difficulty of differentiating manu, delay of delivery, and expiration date. It shows that most of the Western food chefs consider risks of the internal problems at first. 5. A effective outsourcing needs appropriate selection of outsourcing companies, maintenance of credibility, active communication, check and management of hygiene. However regardless of their position or career, chefs in charge of the Western food have the same cognitive attitude toward selecting successful outsourcing companies after the outsourcing system is enforced. The core of cooking, or a final stage in the full process of so-called artistic cooking, should be treated with insourcing. Reduction of several cooking processes resulted in shortened cooking time, increased efficiency, faster cooking, cutting the waiting-lines, and finally more room for customers. The outsourcing system can reduce or eliminate the following processes in cooking: buying various food materials, checking, storing, preparing, and processing. Especially in the Western food cooking department of a hotel, the outsourcing system should be enforced to make an economic kitchen and to efficiently manage it. Wow it's time to change from the traditional kitchen to an economic kitchen in the hotel cooking department. For that, the cooking department should become a small but strong organization by outsourcing except its core work.

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A study on Multiple Entity Data Model Design for Visual-Arts Archives and Information Management in the case of the KS X ISO 23081 Multiple Entity Model (시각예술기록정보 관리를 위한 데이터모델 설계 KS X ISO 23081 다중 엔티티 모델의 적용을 중심으로)

  • Hwang, Jin-hyun;Yim, Jin-hee
    • The Korean Journal of Archival Studies
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    • no.33
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    • pp.155-206
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    • 2012
  • Interests in archives management are getting expanded from the public sector into the cultural and artistic field for the ten years after legislation of "Act on the Management of Public Archives" in 1999. However, due to lack of recognition on the importance of archives in the cultural and artistic field, it is rather frequent that information is kept scattered or archives are lost. As an example, absence of precise contract documents or notes of bestowal keeps people from locating great amount of cultural properties, and because of it these creative properties are in the risk of thefts, the closed-door auctioning, or trades in unofficial channels. As how a nation manages cultural and artistic creation inside the nation reflects its cultural level, it can be said that one of the indexes to notice the extent of a nation's cultural level is to take a look at how they are circulated. This study started from this point. Growing economy and rising interests in culture and art made the society more cognizant of the importance and value that visual artworks have, but the archives and information which are showing the context of these artworks and are produced in the course of social interaction are relatively disregarded because too much emphasis lies on the work itself. It is harder to find archives or documentations in Korea than in other advanced countries about the artists themselves or philosophical discourse on the background of the artworks. There is not so much interest to preserve the archives and information produced after the exhibition also, and they are used for no more than promotion or reference. Hereupon, the researcher recognized the importance of visual arts archives and believed that systemic management on them are high in need. And metadata is an essential way for the systemic management, as recently management on artworks or their archives are conducted using the system of the agencies even though they are not produced electronically. The objective of this study is to manage visual arts archives systematically by designing a data model reflecting traits of visual arts archives. Metadata are needed in the every course of archives from acquisition to management, preservation and application. Visual arts archives find its rich value only when a systemic relationship is established among information on artist, artwork and events including exhibition. By establishing a Multiple Entity Data Model, in which artworks, artists and events (exhibitions) make relationship all together, metadata for management on visual arts archive gets more efficiency and at the same time explanatory trait of the archive gets higher. For this reason we, in the study, tried to design a data model by setting each as an independent entities and designating relations between them, in order to find a way to manage visual arts archives more systematically.

Extrauterine Growth Restriction in Very Low Birth Weight Infants (극소 저체중 출생아의 자궁 외 성장 지연)

  • Kim, Eun-Sun;Sohn, Jin-A;Lee, Eun-Hee;Choi, Eun-Jin;Lee, Hyun-Ju;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.17 no.1
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    • pp.53-63
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    • 2010
  • Purpose : Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR. Methods : The study subjects consisted of very low birth weight (VLBW) infants with a gestational age $\leq$32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge. Results : The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group. Conclusion : EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.

Timing and Risk Factors of Adoption for Legally-Free Foster Children after Having Parental Rights Terminated in the U. S. (미국 위탁아동의 친권상실선고 이후 입양 결정요인에 관한 생존분석)

  • Song, Min-Kyoung
    • Korean Journal of Social Welfare
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    • v.59 no.1
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    • pp.301-327
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    • 2007
  • The purpose of this study is to examine the timing and the risk factors associated with the adoption of legally-free foster children. The sample of the study was drawn from foster care files of Adoption and Foster Care Analysis and Reporting System(AFCARS) in 32 states between October 1998 (FY 1999) and September 2002(FY 2002). The timing post-TPR to adoption was examined by plotting the Kaplan-Meier cumulative hazard function for adoption and by plotting the KM hazard functions stratified by child's race and child's age at TPR. Cox proportional-hazards regression analysis was used to identify risk factors for adoption of legally-free foster children after TPR. The hazard of adoption was very low immediately after TPR but increased steadily starting at 3 months and then declined after 20 months. The cumulative hazard functions for White non-Hispanic children and Black non-Hispanic children crossed over at 13 months after TPR. Racial minority status, older age, and disability were negatively associated with the hazard of adoption. Physical abuse, sexual abuse had the lower hazard for adoption compared by neglect. Caretaker's inability to cope had the slightly lower hazard for adoption whereas inadequate housing showed the slightly greater hazard for adoption. Characteristics of foster care services turned into be powerful predictors of adoption. Specifically, legally-free children placed in pre-adoptive homes, those who shared the same racial/ethnic background with their foster caretakers, and those who were placed in two-parent families have a greater likelihood of adoption. The findings highlight the importance of foster care service provisions after TPR to facilitate adoption of legally-free foster children. Furthermore, a more substantial resources and targeted support for foster children who experience physical abuse and sexual abuse in need of adoption should be provided for moving the foster children into permanency.

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A Study on Entrepreneurship and the Effects of Entrepreneurship Education Program on Entrepreneurship Intention and Entrepreneurship Behavior of University Students (대학생의 기업가정신과 창업교육프로그램이 창업의지와 창업행동에 미치는 영향에 관한 연구)

  • Bae, Byung Yun
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.17 no.4
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    • pp.115-125
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    • 2022
  • In today's era when the concept of a lifelong job has disappeared, starting a business is an essential consideration for university students not only as an alternative factor in finding employment, but also from the perspective of the entire life. Today, most universities in Korea are operating entrepreneurship education programs, such as entrepreneurship classes as a curriculum, and start-up clubs as a non-curricular program to foster entrepreneurship among university students. In previous studies, entrepreneurship is a factor influencing the entrepreneurship intention. The purpose of this study is to empirically examine the effects of university students' entrepreneurship and the entrepreneurship intention through a entrepreneurship education program (participation in a start-up club, taking an entrepreneurship course) on entrepreneurship behavior. There are some empirical studies on whether entrepreneurship education programs such as participation in startup contests affect the entrepreneurship intention of university students, but not much compared to their importance. It is difficult to find an empirical study examining the effects of entrepreneurship and start-up education programs on entrepreneurship intention and entrepreneurship behavior in domestic and foreign studies. Therefore, in this study, one domestic university that operates a start-up club and a entrepreneurship course was selected and the online questionnaire was distributed to all current students, and the collected 127 questionnaires were used for empirical analysis As a result of the study, first, it was confirmed that initiative and risk-taking, which are sub-factors of entrepreneurship of university students, had a significant positive effect on entrepreneurial intention, respectively, and that innovation did not have a significant positive effect. Second, it was confirmed that university students' participation in a start-up club, a sub-factor of the start-up education program, had a significant positive effect on their entrepreneurial intention, and that taking a start-up course did not have a significant positive effect. Third, it was confirmed that the entrepreneurial intention of university students had a significant positive effect on entrepreneurship behavior. Fourth, it was confirmed that the entrepreneurial intention had a mediating effect between each of the factors of risk-taking, and participation in a start-up club and entrepreneurial behavior. This study suggests that university students can increase their risk-taking, increase their entrepreneurial intention by participating in a startup club, and reach a entrepreneurial behavior through this as a medium.