From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.
Necrosis is characterized by the cell membrane rupture and release of the cellular contents, including high-mobility group box 1 protein (HMGB1), into the extracellular microenvironment. HMGB1 acts as a transcriptional regulator in nuclei, but exerts a pro-inflammatory and tumor-promoting cytokine activity when released into the extracellular space. Its overexpression is associated with tumor progression and chemoresistance. Thus, HMGB1 acts as a clinically important molecule in tumor biology. In this study, we examined whether HMGB1 affects cell death induced by anti-cancer drugs. Here we show that HMGB1 prevented cisplatin (alkylating agent)-induced apoptosis and switched the cell fate to necrosis in MCF-7, MDA-MB231, and MDA-MB361 cells. Similar apoptosis-to-necrosis switch effects of HMGB1 were observed in cells treated with 4-HC, another alkylating agent. In contrast, HMGB1 did not exert any significant effects on docetaxel (DOC)-induced apoptosis in MCF-7 cells. We also show that cisplatin-induced apoptosis was switched to necrosis in MCF-7 multicellular tumor spheroids (MTS) that were cultured for 8 days and had necrotic cores, but DOC-induced apoptosis was prevented without the apoptosis-to-necrosis switch. Finally, the levels of RAGE, a receptor of HMGB1, were increased with extended culture of MTS. These findings demonstrate that HMGB1 switches alkylating agent-induced apoptosis to necrosis, suggesting that the strategy to prevent necrosis occurring as an undesirable action of alkylating agent-based chemotherapy should be delineated to improve the efficacy of chemotherapy for cancer.
Machine learning is a field of artificial intelligence. It refers to an area of computer science related to providing machines the ability to perform their own data analysis, decision making and forecasting. For example, one of the representative machine learning models is artificial neural network, which is a statistical learning algorithm inspired by the neural network structure of biology. In addition, there are other machine learning models such as decision tree model, naive bayes model and SVM(support vector machine) model. Among the machine learning models, we use SVM model in this study because it is mainly used for classification and regression analysis that fits well to our study. The core principle of SVM is to find a reasonable hyperplane that distinguishes different group in the data space. Given information about the data in any two groups, the SVM model judges to which group the new data belongs based on the hyperplane obtained from the given data set. Thus, the more the amount of meaningful data, the better the machine learning ability. In recent years, many financial experts have focused on machine learning, seeing the possibility of combining with machine learning and the financial field where vast amounts of financial data exist. Machine learning techniques have been proved to be powerful in describing the non-stationary and chaotic stock price dynamics. A lot of researches have been successfully conducted on forecasting of stock prices using machine learning algorithms. Recently, financial companies have begun to provide Robo-Advisor service, a compound word of Robot and Advisor, which can perform various financial tasks through advanced algorithms using rapidly changing huge amount of data. Robo-Adviser's main task is to advise the investors about the investor's personal investment propensity and to provide the service to manage the portfolio automatically. In this study, we propose a method of forecasting the Korean volatility index, VKOSPI, using the SVM model, which is one of the machine learning methods, and applying it to real option trading to increase the trading performance. VKOSPI is a measure of the future volatility of the KOSPI 200 index based on KOSPI 200 index option prices. VKOSPI is similar to the VIX index, which is based on S&P 500 option price in the United States. The Korea Exchange(KRX) calculates and announce the real-time VKOSPI index. VKOSPI is the same as the usual volatility and affects the option prices. The direction of VKOSPI and option prices show positive relation regardless of the option type (call and put options with various striking prices). If the volatility increases, all of the call and put option premium increases because the probability of the option's exercise possibility increases. The investor can know the rising value of the option price with respect to the volatility rising value in real time through Vega, a Black-Scholes's measurement index of an option's sensitivity to changes in the volatility. Therefore, accurate forecasting of VKOSPI movements is one of the important factors that can generate profit in option trading. In this study, we verified through real option data that the accurate forecast of VKOSPI is able to make a big profit in real option trading. To the best of our knowledge, there have been no studies on the idea of predicting the direction of VKOSPI based on machine learning and introducing the idea of applying it to actual option trading. In this study predicted daily VKOSPI changes through SVM model and then made intraday option strangle position, which gives profit as option prices reduce, only when VKOSPI is expected to decline during daytime. We analyzed the results and tested whether it is applicable to real option trading based on SVM's prediction. The results showed the prediction accuracy of VKOSPI was 57.83% on average, and the number of position entry times was 43.2 times, which is less than half of the benchmark (100 times). A small number of trading is an indicator of trading efficiency. In addition, the experiment proved that the trading performance was significantly higher than the benchmark.
This study aims to analyze the landscape ecological characteristics of green spaces within built up area of high density and evaluate the potential applicability of green patches, thereby introducing urban garden for generating green networks in residence areas. To this end, Yeoksam-Dong was selected as the site area since it is classified as both green initiative zone and alienated area of park service in Seoul. First, the current condition of green spaces in Yeoksam-Dong was identified by five categories: Street trees, private garden, public pocket garden, rooftop garden, and park. Then, the landscape index analysis through FRAGSTATS and connectivity assessment via multi-buffer zone analysis were carried out for analyzing the green networks and evaluating the potential value of green space. The results showed that the degree to which green areas in the site were distributed is arranged in the order of street tree, private garden, public pocket garden, park, and rooftop garden. In case of the street trees whose total core area (TCA, $1,618m^2$) is as high as the park's ($1,128m^2$). Private garden has potential for green network in built up area of high density by gardening since the shape of the patches are irregular (ED = 78.1m/ha) and the average distance among the patches is close (ENN=33.9m). Public pocket garden has also potential for gardening according to the result that it was found to be distributed evenly (LPI=5.7%, SHEI=0.9) with exposing external disturbance ($TCA=66m^2$). For the green network, 84% of all the study site is covered by small green network in 50m butter range of connected green area. The effect of green network was expected through gardening in public pocket garden (27%) and street tree (26%). Accordingly, it is encouraged to actively utilize street tree, private gardens, and rooftop gardens and to establish the urban gardens like local-based community gardens in public pocket garden where a variety of activities can be carried out near residential areas. By doing so, green networks can effectively be established in built up area with high density. The results of this study can contribute positively to fostering the creation of various types of urban gardens.
A self-sufficiency service has worked as a typical workfare policy combined with public assistance in Korea since 2000. Despite of its long history, three core pillars in administrating the self-sufficiency service, policy, research, and practice, have respectively understood the meaning of self-sufficiency in terms of their own interests. As a result, the self-sufficiency service has recently faced with its own identity issues by showing failures to its environmental changes. The current situation makes it necessary to reconceptualize the definition of self-sufficiency by exploring its in-depth understanding perceived by service providers. Specifically, we analyzed practical reflections on 35 service providers' experiences which were collected via focus group interviews for two hours. The study findings presented that service providers had two antithetical approaches towards self-sufficiency. While a dominant approach to self-sufficiency has been concentrated on improving clients' economic outcomes such as employment, job retention, the escape from welfare trap, and increasing earnings and assets, the other approach has been extended to empower clients and achieve their well-being and quality of life. Yet, these contrary perspectives have led to suffer from their role confusions and identity crisis between the work-ready process and the employment-oriented outcomes. Specifically, they described self-sufficiency in terms of psychological, social, and integrated aspects. The psychological aspect included a process of developing inner strengths, intensifying job motivation, and coping with barriers of employment. The social aspect meant a path toward social integration through recovering human relationships. The integrated aspect covered more comprehensive support for their recovery of daily life and autonomy to make a decision for their own life. In conclusion, the study findings suggest that self-sufficiency should be more extensively considered as a stepwise process towards work-ready preparations beyond ultimate economic outcomes. Such an extended concept of self-sufficiency could contribute to restructuring the whole practice of self-sufficiency including organizational and program changes in the fields.
In 2017, the U.S. DARPA coined 'mosaic warfare' as a new way of warfighting. According to the Timothy Grayson, director of DARPA's Strategic Technologies Office, mosaic warfare is a "system of system" approach to warfghting designed around compatible "tiles" of capabilities, rather than uniquely shaped "puzzle pieces" that must be fitted into a specific slot in a battle plan in order for it to work. Prior to cover mosaic warfare theory and recent development, it deals analyze its background and several premises for better understanding. The U.S. DoD officials might acknowledge the current its forces vulnerability to the China's A2/AD assets. Furthermore, the U.S. seeks to complete military superiority even in other nation's territorial domains including sea and air. Given its rapid combat restoration capability and less manpower casualty, the U.S. would be able to ready to endure war of attrition that requires massive resources. The core concept of mosaic warfare is a "decision centric warfare". To embody this idea, it create adaptability for U.S. forces and complexity or uncertainty for the enemy through the rapid composition and recomposition of a more disag g reg ated U.S. military force using human command and machine control. This allows providing more options to friendly forces and collapse adversary's OODA loop eventually. Adaptable kill web, composable force packages, A.I., and context-centric C3 architecture are crucial elements to implement and carry out mosaic warfare. Recently, CSBA showed an compelling assessment of mosaic warfare simulation. In this wargame, there was a significant differences between traditional and mosaic teams. Mosaic team was able to mount more simultaneous actions, creating additional complexity to adversaries and overwhelming their decision-making with less friendly force's human casualty. It increase the speed of the U.S. force's decision-making, enabling commanders to better employ tempo. Consequently, this article finds out and suggests implications for Korea armed forces. First of all, it needs to examine and develop 'mosaic warfare' in terms of our security circumstance. In response to future warfare, reviewing overall force structure and architecture is required which is able to compose force element regardless domain. In regards to insufficient defense resources and budget, "choice" and "concentration" are also essential. It needs to have eyes on the neighboring countries' development of future war concept carefully.
Kim, Doehyung;Kim, Min-Jeong;Lee, Haeyoung;Kim, Hyunseuk;Kim, Youngmi;Lee, Sang-Shin
Korean Journal of Psychosomatic Medicine
/
v.29
no.1
/
pp.49-57
/
2021
Objectives : This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods : A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results : There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions : Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.
In this study, we investigated the mineral geochemistry of the albite-spodumene pegmatite, associated exogreisen, and wall rock from the Boam Li deposit, Wangpiri, Uljin, Gyeongsangbuk-do, South Korea. The paragenesis of the Boam Li deposit consists of two stages; the magmatic and endogreisen stages. In the magmatic stage, pegmatite dikes mainly composed of spodumene, albite, quartz, and K-feldspar intruded into the Janggun limestone formation. In the following endogreisen stage, the secondary fine-grained albite along with muscovite, apatite, beryl, CGM(columbite group mineral), microlite, and cassiterite were precipitated and partly replaced the magmatic stage minerals. Exogreisen composed of tourmaline, quartz, and muscovite develops along the contact between the pegmatite dike and wall rock. The Cs contents of beryl and muscovite and Ta/(Nb+Ta) ratio of CGM are higher in the endogreisen stage than the magmatic stage, suggesting the involvement of the more evolved melts in the greisenization than in the magmatic stage. Florine-rich and Cl-poor apatite infer that the parental magma is likely derived from metasedimentary rock (S-type granite). P2O5 contents of albite in the endogreisen stage are below the detection limit of EDS while those of albite in the magmatic stage are 0.28 wt.% on average. The lower P2O5 contents of the former albite can be attributed to apatite and microlite precipitation during the endogreisen stage. Calcium introduced from the adjacent Janggun formation may have induced apatite crystallization. The interaction between the pegmatite and Janggun limestone is consistent with the gradual increase in Ca and other divalent cations and decrease in Al from the core to the rim of tourmaline in the exogreisen.
The purpose of this study is to analyze the human rights found in the North Korean Constitution and their core problem by focusing on elements of human rights suggested by Daesoon Jinrihoe's doctrine of Haewon-sangsaeng (解冤相生 the Resolution of Grievances for Mutual Beneficence). Haewon-sangsaeng is seemingly the only natural law that could resolve human resentment lingering from the Mutual Contention of the Former World while leading humans work for the betterment of one another. Haewon-sangsaeng, as a natural law, includes the right to life, the right to autonomous decision-making, and duty to act according to human dignity (physical freedom, the freedom of conscience, freedom of religion, freedom of speech, freedom of press, etc.), the right to equal treatment in one's social environment, and the right to ensure the highest level of health through treatment. The North Korean Constitution does not have a character as an institutional device to guarantee natural human rights, the fundamental principle of the Constitution, and stipulates the right of revolutionary warriors to defend dictators and dictatorships. The right to life is specified so that an individual's life belongs to the life of the group according to their socio-political theory of life. Rights to freedom are stipulated to prioritize group interests over individual interests in accordance with the principle of collectivism. The right to equality and the right to health justify discrimination through class discrimination. The right to life provided to North Koreans is not guaranteed due to the death penalty system found within the North Korean Criminal Code and the Criminal Code Supplementary Provisions. The North Korean regime deprives North Koreans of their right to die with dignity through public executions. The North Korean regime places due process under the direction of the Korea Worker's Party, recognizes religion as superstition or opium, and the Korea Worker's Party acknowledge the freedoms of bodily autonomy, religion, media, or press. North Koreans are classified according to their status, and their rights to equality are not guaranteed because they are forced to live a pre-modern lifestyle according to the patriarchal order. In addition, health rights are not guaranteed due biased availability selection and accessibility in the medical field as well as the frequent shortages of free treatments.
The purpose of this study is to develop a substantive theory on 'eating alone'(honbob)and the process of maintaining the lifestyle of eating alone for the need of a non-judgmental understanding on the new 'honbob' lifestyle. Data were collected through in-depth interviews with 10 male and female workers in Seoul and Gyeonggi-do, who voluntarily eat alone over 70% of their meals per week with the minimum duration of 5 years. Data analysis was performed using grounded theory proposed by Strauss & Corbin (1998) in the qualitative research method. As a result, a paradigm model on the process of maintaining 'honbob' was derived. Based on categorical analysis, the causal condition was 'not trying to tune' and the central phenomenon was 'following the desire to set efficiency as the top priority. Contextual conditions were 'the atmosphere of fierce competition', 'weakening of organizational culture', 'diffusion of individualistic culture'. The intervening conditions were 'personal trait and emotional experience', 'job characteristics of less organization culture'. The action/interaction strategies were 'accepting internal conflicts', 'acting in autonomy', 'finding relationship through media', and 'distancing from superficial relationship'. The consequences were 'enjoying time for self-exploration', 'valuing self-care', 'becoming a epicurean conventionalist', and 'becoming aware of the need for balance'. The core category has been shown as 'self-oriented in accordance to priority of efficiency and being able to appreciate the importance of social group'. The Such phenomenon passes through four different stages - first, the stage of weighing time efficiency while beginning hon-bob; second, the stage of conflict when one feels nervous and not free from others' view; third, the stage of adjustment to justify his/her 'hon-bob'; and the final stage of balance to perceive the importance of social group while going on 'honbob'. The study had the aim of increasing the understanding and acceptance of the new 'honbob' lifestyle through an in-depth exploration of office worker's 'honbob' experience and the process of maintaining 'honbob' so the society can better accept it and, further, to embrace co-existence of various cultures.
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