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Developing a Composite Quality Indicator to Assess The Quality of Care for US Medicare End-stage Renal Disease Patients (미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로)

  • Kang, Hye-Young
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.204-216
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    • 2000
  • Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

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Antimicrobial Activity and Components of Extracts from Agastache rugosa during Growth Period

  • Song, Jong-Ho;Kim, Min-Ju;Kwon, Hyuk-Dong;Park, In-Ho
    • Preventive Nutrition and Food Science
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    • v.6 no.1
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    • pp.10-15
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    • 2001
  • Antimicrobial activities of volatile flavor, water and methanol extracts from Agastache rugosa were investigated. The volatile flavor extract was obtained from A. rugosa by simulataneous distillation-extraction (SDE) method. Antimicrobial activity was investigated by disc diffusion method against several microorganisms, four species of Gram positive, three species of Gram negative and tow species of yeast. The volatile flavor extracts had strong antimicrobial activity againstc. utilisand S. cerevisiae. During the growth period, a difference in antimicrobial activity among volatile flavor extracts from A. rugosa was not shown. The water extract of above 10 mg/disc showed antimicrobial activity. Methanol extracts from A. rugosa harvested in June showed antimicrobial activity against tested Gram positive and Gram negative bacteria, showed weak antimicrobial activity against the bacteria from those harvested in July and August. In particular, antimicrobial activity against V. parahaemolyticus was stronger than that against other bacteria. Water and methanol extracts did not inhibit yeast. C. utilis and S. cerevisiae. To further elucidate the effective components, volatile flavor extracts was analyzed by GC/MS. harvested in June, the components included 8 phenols (93.031%), 18 terpenes (5.230%), 12 alcohols (1.300%) 8 alkanes (0.181%), 1 ester (0.056%), 2 ketones (0.033%), 2 aldehydes (0.011%) and 1 pyrrole (0.007%). In July, the components included 6 phenols (94.366%), 19 terpenes (3.394%), 11 alcohols (2.045%), 1 ester (0.039%), 2 ketones (0.028%), 1 furan (0.005%) and 1 aldehyde (0.005%). And in August, the components included 7 phenols (95.270%), 19 terpenes (2.951%), 13 alcohols (1.399%), 1 ester (0.063%), 2 aldehydes (0.016%), 2 ketones (0.011%), 1 alkane (0.006%), 1 acid (0.005%) and 1 pyrrole (0.005%). The major component of volatile flavors was estragole, a phenolic compound.

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Effect of Soil Moisture on Nitrogen Fixation Activity of Rhizobium in Soybean (토양수분 차이가 대두 근류균의 질소고정에 미치는 영향)

  • 김용철;최인수
    • Journal of Life Science
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    • v.12 no.5
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    • pp.544-548
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    • 2002
  • The object of this study was to investigate nitrogen fixation activity of rhizobium inoculated at seed coat when drought condition was applied in flowering period of soybean c.v. Samnamkong. The rhizobia used in this experiment were indigenous rhizobium, R2l4, RJl-29, USDA110 and USDA122. The experiment was done with 1/2000 Wagner pots in laboratory and greenhouse and was tested in completely randomized design with four replications. Nitrogen fixation activity in coventional culture was the highest in R2l4 and indigenous rhizobium among the five rhizobia strains. As given drought condition from flowering to maturity, nitrogen fixation activity was higher in R2l4 and RJl-29 than indigenous rhizobium. Leaf area and relative index (drought/convention) of pod weight were higher in USDA122, RJl-29 and R2l4 than indigenous rhizobium as given drought condition from flowering to maturity. High positive correlation was observed between nitrogen fixation activity of rhizobium and relative index(drought/convention) of pod weight. High negative correlation was observed between respiration of plant and relative index (drought/convention) of leaf area.

Structural Stability During Charge-Discharge Cycles in Zr-doped LiCoO2 Powders (충방전 과정중 구조가 안정한 Zr이 도핑된 LiCoO2 분말)

  • Kim, Seon-Hye;Shim, Kwang-Bo;Ahn, Jae-Pyoung;Kim, Chang-Sam
    • Journal of the Korean Ceramic Society
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    • v.45 no.3
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    • pp.167-171
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    • 2008
  • Zirconium-doped $Li_{1.1}Co_{1-x}Zr_xO_2(0{\leq}x{\leq}0.05)$ powders as cathode materials for lithium ion batteries were synthesized using an ultrasonic spray pyrolysis method. Cyclic voltammetry and cyclic stability tests were performed, and the changes of microstructure were observed. The solubility limit of zirconium into $Li_{1.1}CoO_2$ was less than 5 mol%, and monoclinic $Li_2ZrO_3$ phase was formed above the limit. The Zr-doping suppressed the grain growth and increased the lattice parameters of the hexagonal $LiCoO_2$ phase. The Zr-dopiong of 1mol% resulted in the best cyclic performance in the range of $3.0{\sim}4.3V$ at 1C rate (140 mA/g); the initial discharge capacity decreased from 158 mAh/g to 60 mAh/g in the undoped powder, while from 154 mAh/g to 135 mAh/g in the Zr-doped powder of 1 mol% after 30 cycles. The excellent cycle stability of Zr-doped powder was due to the low polarization during chargedischarge processes which resulted from the delayed collapse of the crystal structure of the active materials with Zr-doping.

Electrochemical methodologies for fabrication of urea-sensitive electrodes composed of porous silicon layer and urease-immobilized conductive polymer film (전기화학적 방법을 이용한 다공질 실리콘 구조 형성, 전도성 고분자코팅, 및 urease 고정화와 감도 특성)

  • Jin, Joon-Hyung;Kang, Moon-Sik;Song, Min-Jung;Min, Nam-Ki;Hong, Suk-In
    • Proceedings of the KIEE Conference
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    • 2003.07c
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    • pp.1938-1940
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    • 2003
  • 본 연구는 요소 센서 제작을 위한 과정으로서, 전기화학적 방법을 이용한 다공질 실리콘 구조 형성과, PDV(Physical Vapor Deposition) 법에 의한 백금 박막 코팅 및 전기화학적 전도성 고분자 코팅과 urease 고정화 단계를 고찰하고 감도 특성을 제시 하였다. 전극 기질로서 B을 도우핑한 p-type 실리콘웨이퍼를 사용하였고, HF:$C_2H_5OH:H_2O$=1:2:1의 부피비를 갖는 에칭 용액에서 5분간 -7 $mA/cm^2$의 일정 전류를 가하여 폭 2 ${\mu}m$, 깊이 10 ${\mu}m$의 다공질 실리콘(PS) 충을 형성하였다. 그 위에 200 ${\AA}$의 Ti 층을 underlayer로서 증착하고, 2000 ${\AA}$의 Pt를 중착하여 PS/Pt 박막 전극을 제작하고, 전도성 고분자로서 polypyrrole (PPy), 또는 poly(3-mehylthiophene) (P3MT)을 전기화학적으로 코팅한 후, urease(EC 3.5.1.5, type III, Jack Bean, Sigma)를 고정화 하였다. 고정화 시 전해질 수용액의 pH는 7.4로 하여 urease표면이 음전하를 갖도록 하고, 전극에 0.6 V (vs. SCE(Saturated Calomel Electrode))의 일정 전압을 가함으로써 urease가 전도성 고분자 표면에 전기적으로 흡착되도록 하였다. 이상의 방법으로 제작한 요소 센서의 감도는 PPy와 P3MT를 전자 전달 매질로 사용한 경우, 각각 8.44 ${\mu}A/mM{\cdot}cm^2$와 1.55 ${\mu}A/mM{\cdot}cm^2$의 감도를 보였다.

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Chemical States and Microstructures of Anodic TiO2 Layers (양극산화 TiO2 피막의 화학 결합상태와 미세구조)

  • Jang, J.M.;Oh, H.J.;Lee, J.H.;Joo, J.H.;Chi, C.S.
    • Korean Journal of Materials Research
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    • v.12 no.7
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    • pp.528-532
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    • 2002
  • Anodic $TiO_2$film on Ti substrate was fabricated at 180V in sulfuric acid solutions containing phosphoric acid and hydrogen peroxide. Effects of the anodizing conditions on the morphology of the oxide layers, and chemical states of the component elements of the layers were studied primarily using SEM, XRD, AFM, and XPS. The pores in the oxide layer was not uniform in size, shape, and growth direction particularly near the interface between the substrate and the oxide layer, compared with those of the surface layer. The formation of irregular type of pores seemed to be attributed to spark discharge phenomena which heavily occurred during increasing the anodic voltage. The pore diameter and the cell size increased, and the number of cells per unit area decreased with the increasing time. From the XPS results, it was shown that component elements of the electrolytes, P and S, existed in the chemical states of $PO_4^{-3}$ , $P_2$$O_{5}$, $SO_4^{-2}$ , $SO_3^{-2}$ , P, S, etc., which were penetrated from the electrolytes into the oxide layer during anodization.

Bandgap Control of (AlxGa1-x)2O3 Epilayers by Controlling Aqueous Precursor Mixing Ratio in Mist Chemical Vapor Deposition System (미스트화학기상증착시스템의 전구체 수용액 혼합비 조절을 통한 (AlxGa1-x)2O3 에피박막의 밴드갭 특성 제어 연구)

  • Kim, Kyoung-Ho;Shin, Yun-Ji;Jeong, Seong-Min;Bae, Si-Young
    • Journal of the Korean Institute of Electrical and Electronic Material Engineers
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    • v.32 no.6
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    • pp.528-533
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    • 2019
  • We investigated the growth of $(Al_xGa_{1-x})_2O_3$ thin films on c-plane sapphire substrates that were grown by mist chemical vapor deposition (mist CVD). The precursor solution was prepared by mixing and dissolving source materials such as gallium acetylacetonate and aluminum acetylacetonate in deionized water. The [Al]/[Ga] mixing ratio (MR) of the precursor solution was adjusted in the range of 0~4.0. The Al contents of $(Al_xGa_{1-x})_2O_3$ thin films were increased from 8 to 13% with the increase of the MR of Al. As a result, the optical bandgap of the grown thin films changed from 5.18 to 5.38 eV. Therefore, it was determined that the optical bandgap of grown $(Al_xGa_{1-x})_2O_3$ thin films could be effectively engineered by controlling Al content.

Growth Behaviors of Anodic Titanium Oxide Nanotubes in the Ethylene Glycol Solution According to Water Contents (에틸렌 글리콜 용액에서 물 함량에 따른 티타늄 양극산화 나노튜브의 성장거동)

  • Lee, Byunggwan;Lee, Seongeun;Choi, Jinwook;Jeong, Yongsoo;Oh, Han-Jun;Lee, Oh Yeon;Chi, Choong-Soo
    • Korean Journal of Metals and Materials
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    • v.46 no.11
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    • pp.730-736
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    • 2008
  • $TiO_2$ nanotubes fabricated in aqueous HF-based electrolytes have been generally grown only to about 500nm in length because of the strong dissolubility of HF acid. In this paper, ethylene glycol solution has been applied for increasing the length of the anodic $TiO_2$ nanotubes, and the growth behaviors of the nanotubes according to water contents has been investigated. Anodization of Ti in ethylene glycol + 1 wt% $NH_4F$ (EG solution) with water additions up to 10 wt% were carried out at the constant voltage of 20 V. The results show that a thin titanium oxide layer is formed in the initial stage and the nanotube structure grows underneath the initial layer. And the length of $TiO_2$ nanotubes decreases with the increasing water content in the solution. It can be ascribed to the locally acidified circumstance around the barrier layer inside the nanopore due to $H^+$ ion originated from water. The XPS for the nanotubes suggests that the spectra of Ti2p and O1s are the major chemical bonding states of the $TiO_2$, and those for F1s, N1s and C1s come from the compound of $(NH_4)_2TiF_6$.

Improving Electrochemical Performance of Ni-rich Cathode Using Atomic Layer Deposition with Particle by Particle Coating Method

  • Kim, Dong Wook;Park, DaSom;Ko, Chang Hyun;Shin, Kwangsoo;Lee, Yun-Sung
    • Journal of Electrochemical Science and Technology
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    • v.12 no.2
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    • pp.237-245
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    • 2021
  • Atomic layer deposition (ALD) enhances the stability of cathode materials via surface modification. Previous studies have demonstrated that an Ni-rich cathode, such as LiNi0.8Co0.1Mn0.1O2, is a promising candidate owing to its high capacity, but is limited by poor cycle stability. In this study, to enhance the stability of the Ni-rich cathode, synthesized LiNi0.8Co0.1Mn0.1O2 was coated with Al2O3 using ALD. Thus, the surface-modified cathode exhibited enhanced stability by protecting the interface from Ni-O formation during the cycling process. The coated LiNi0.8Co0.1Mn0.1O2 exhibited a capacity of 176 mAh g-1 at 1 C and retained up to 72% of the initial capacity after 100 cycles within a range of 2.8-4.3 V (vs Li/Li+. In contrast, pristine LiNi0.8Co0.1Mn0.1O2 presented only 58% of capacity retention after 100 cycles with an initial capacity of 173 mAh g-1. Improved cyclability may be a result of the ALD coating, which physically protects the electrode by modifying the interface, and prevents degradation by resisting side reactions that result in capacity decay. The electrochemical impedance spectra and structural and morphological analysis performed using electron microscopy and X-ray techniques establish the surface enhancement resulting from the aforementioned strategy.

Effects of Sodium and Gallium on Characteristics of CIGS Thin Films and CdS/CIGS Solar Cells by Co-evaporation Method (Na확산과 Ga첨가에 따른 동시진공증발법으로 제조된 CIGS 박막과 CdS/CIGS 태양전지의 특성)

  • Kwon, S.H.;Lee, J.C.;Kang, K.H.;Kim, S.K.;Yoon, K.H.;Song, J.S.;Lee, D.Y.;Ahn, B.T.
    • Solar Energy
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    • v.20 no.2
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    • pp.43-54
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    • 2000
  • We prepared and characterized $Cu(In_{1-x}Ga_x)Se_2$(CIGS) films using a elemental co-evaporation method for absorbing layer of high efficiency thin film solar cells. The CIGS films deposited on a soda-lime glass exhibited low resistivity because of higher carrier concentration. Na was accumulated at the CIGS surface and the 0 and Se were also accumulated at the surface, suggesting that oxidation is a driving force of Na accumulation. The structure of CIGS film was modified or a secondary phase was formed in the Cu-poor CIGS bulk films probably due to the incorporation of Na into Cu vacancy sites. As the Ga/(In+Ga) ratio increased, the diffraction peaks of $Cu(In_{1-x}Ga_x)Se_2$ films were shifted to larger angle and splitted, and the grain size of $Cu_{0.91}(In_{1-x}Ga_x)Se_2$ films became smaller. All $Cu_{0.91}(In_{1-x}Ga_x)Se_2$ films showed the p-type conductivity regardless of the Ga/(In+Ga) ratio. Ag/n-ZnO/i-ZnO/CdS/$Cu_{0.91}(In_{0.7}Ga_{0.3})Se_2$/Mo solar cells were fabricated. The currently best efficiency in this study was 14.48% for $0.18cm^2$ area ($V_{oc}=581.5mV,\;J_{sc}=34.88mA$, F.F=0.714).

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