• Industrial Engineering and Management Systems
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• v.11 no.3
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• pp.233-240
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• 2012

The implementation of business process management (BPM) systems in large number of business organizations transforms BPM system into such a level of maturity and tends to collect large repositories of business process (BP) models. This issue encourages BP flexibility that leads to a large number of process variants derived from the same model, but differing in structure, to be stored in the large repositories of BP models. Therefore, the repositories may include thousands of activities and related business objects with variation of requirements and quality of service. It is a common practice to customize processes from reference processes or templates in order to reduce the time and effort required to design and deploy processes on all levels. In order to address redundancy and underutilization problems, a generic process model, called as reference BP, is absolutely necessary to cover the best of process variants. This study aims to develop multiple-objective business process genetic algorithm (MOBPGA) to find a set of non-dominated (Pareto) solutions of business reference model to enhance conventional approach which considered only a single objective on creating BP reference model by using proximity score measurement. A mixed-integer linear program is constructed to evaluate performance of the proposed MOBPGA on small-scale problems by using standard measures for multiple-objective techniques. The results will show the viability of applying MOBPGA in terms of simultaneously maximizing proximity score measurement, minimizing total duration, and total costs of the selected reference model.

• Health Policy and Management
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• v.31 no.2
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.225-232
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• 2022

Background: Pulmonary lobectomy is the standard of care for the treatment of early-stage non-small cell lung cancer. This study investigated the rate of utilization of supplemental anesthesia in patients undergoing video-assisted thoracoscopic surgery (VATS) or open lobectomy using a national database and assessed the effect of regional block (RB) on postoperative outcomes. Methods: Patients who underwent lobectomy for lung cancer between 2014-2019 were identified in the American College of Surgeons National Surgical Quality Improvement Program. The patients' primary mode of anesthesia and supplemental anesthesia were recorded. Preoperative characteristics and postoperative outcomes were compared between 2 surgical groups: those who underwent general anesthesia (GA) alone versus GA with RB. Multivariable regression analyses were performed on the outcomes of interest. Results: In total, 13,578 patients met the study criteria, with 87% undergoing GA and the remaining 13% receiving GA and RB. The use of neuraxial anesthesia decreased over the years, while RB use increased up to 20% in 2019. Age, body mass index, and preoperative comorbidities were comparable between groups. Patients who underwent VATS were more likely to receive RB than those who underwent thoracotomy. RB was most often utilized by thoracic surgeons. An adjusted analysis showed that RB use was associated with shorter hospital stays and a reduced likelihood of prolonged length of stay, but a higher rate of surgical site infections (SSIs). Conclusion: In a large surgical database, there was underutilization of supplemental anesthesia in patients undergoing lobectomy for lung cancer. RB utilization was associated with a shorter length of hospital stay and an increase in SSI incidence.

• Applied Microscopy
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• v.51
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• pp.18.1-18.12
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• 2021

Hair, having distinct stages of growth, is a dynamic component of the integumentary system. Nonetheless, derangement in its structure and growth pattern often provides vital clues for the diagnosis of systemic diseases. Assessment of the hair structure by various microscopy techniques is, hence, a valuable tool for the diagnosis of several systemic and cutaneous disorders. Systemic illnesses like Comel-Netherton syndrome, Griscelli syndrome, Chediak Higashi syndrome, and Menkes disease display pathognomonic findings on hair microscopy which, consequently, provide crucial evidence for disease diagnosis. With minimal training, light microscopy of the hair can easily be performed even by clinicians and other health care providers which can, thus, serve as a useful tool for disease diagnosis at the patient's bedside. This is especially true for resource-constrained settings where access and availability of advanced investigations (like molecular diagnostics) is a major constraint. Despite its immense clinical utility and non-invasive nature, hair microscopy seems to be an underutilized diagnostic modality. Lack of awareness regarding the important findings on hair microscopy may be one of the crucial reasons for its underutilization. Herein, we, therefore, present a comprehensive overview of the available methods for hair microscopy and the pertinent findings that can be observed in various diseases.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.260-268
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• 2024

Objectives: Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. Methods: A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. Results: The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). Conclusions: Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.

• The Journal of the Korea Contents Association
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• v.15 no.7
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• pp.1-11
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• 2015

In recent high performance computing system, GPGPU has been widely used to process general-purpose applications as well as graphics applications, since GPU can provide optimized computational resources for massive parallel processing. Unfortunately, GPGPU doesn't exploit computational resources on GPU in executing general-purpose applications fully, because the applications cannot be optimized to GPU architecture. Therefore, we provide GPU research guideline to improve the performance of computing systems using GPGPU. To accomplish this, we analyze the negative factors on GPU performance. In this paper, in order to clearly classify the cause of the negative factors on GPU performance, GPU core status are defined into 5 status: fully active status, partial active status, idle status, memory stall status and GPU core stall status. All status except fully active status cause performance degradation. We evaluate the ratio of each GPU core status depending on the characteristics of benchmarks to find specific reasons which degrade the performance of GPU. According to our simulation results, partial active status, idle status, memory stall status and GPU core stall status are induced by computational resource underutilization problem, low parallelism, high memory requests, and structural hazard, respectively.

• Journal of KIISE:Computing Practices and Letters
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• v.14 no.2
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• pp.191-195
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• 2008

This paper proposes a technique for improving IEEE 802.11e EDCA's performance by dynamically adjusting each class's contention window size based on each class's traffic amount. For providing differentiated service differently from 802.11, 802.11e EDCA maintains four classes each of which specifies different static minimum and maximum contention window sizes. Since the initial window sites significantly affect the 802.11e performance, several window adjustment schemes have been proposed. One of the schemes known as CWminAS (CWmin Adaptation Scheme) dynamically and synchronously determines the four windows' site based on the periodically measured collision rate. This method, however, can lower the send probability of high priority classes since it can't differentiate their collisions from those of low priority classes, leading to the channel underutilization. For solving this problem, we propose ACATICT(Adaptive Contention-window Adjustment Technique based on Individual Class Traffic) algorithm which adapts each class window size based on each individual collision rate rather than one average collision rate. Our simulation experiments show that ACATICT achieves better utilization by around 10% at maximum.

• The Journal of the Korea Contents Association
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• v.13 no.3
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• pp.9-21
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• 2013

Due to increased computing power and flexibility of GPU, recent GPUs execute general purpose parallel applications as well as graphics applications. Programmers can use GPGPU by using the APIs from GPU vendors. Unfortunately, computational resources of GPU are not fully utilized when executing general purpose applications because of frequent branch instructions. To handle the branch problem, several warp formations have been proposed. Intuitively, we expect that the warp formations providing higher computational resource utilization show higher performance. Contrary to our expectations, according to simulation results, the performance of the warp formation providing better utilization is lower than that of the warp formation providing worse utilization. This is because warp formation providing high utilization causes serious memory bottleneck due to increased memory request. Therefore, warp formation providing high computation utilization cannot guarantee high performance without proper hardware resources. For this reason, we will analyze the correlation between hardware configuration and warp formation. Our simulation results present the guideline to solve the underutilization problem due to branch instructions when designing recent GPU.

• Journal of KIISE:Computer Systems and Theory
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• v.37 no.3
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• pp.147-160
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• 2010

The system virtualization shows interest in the consolidation of servers for the efficient utilization of system resources. There are many various researches to utilize a server machine more efficiently through the system virtualization technique, and improve performance of the virtualization software. These researches have studied with the activity to control the resource allocation of virtual machines dynamically focused on CPU, or to manage resources in the cross-machine using the migration. However, the researches of the memory management have been wholly lacking. In this respect, the use of memory is limited to allocate the memory statically to virtual machine in server consolidation. Unfortunately, the static allocation of the memory causes a great quantity of the idle memory and decreases the memory utilization. The underutilization of the memory makes other side effects such as the load of other system resources or the performance degradation of services in virtual machines. In this paper, we suggest the dynamic allocation of the memory in Xen to control the memory allocation of virtual machines for the utilization without the performance degradation. Using AR model for the prediction of the memory usage and ACO (Ant Colony Optimization) algorithm for optimizing the memory utilization, the system operates more virtual machines without the performance degradation of servers. Accordingly, we have obtained 1.4 times better utilization than the static allocation.

• The Journal of Korean Institute of Next Generation Computing
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• v.13 no.3
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• pp.72-83
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• 2017

GPUs can provide high throughput with latency hiding by executing many warps in parallel. MSHR(Miss Status Holding Registers) for L1 data cache tracks cache miss requests until required data is serviced from lower level memory. In recent GPUs, excessive requests for cache resources cause underutilization problem of GPU resources due to cache resource reservation fails. In this paper, we propose a new warp scheduling technique to reduce stall cycles under MSHR resource shortage. Cache miss rates for each warp is predicted based on the observation that each warp shows similar cache miss rates for long period. The warps showing low miss rates or computation-intensive warps are given high priority to be issued when MSHR is full status. Our proposal improves GPU performance by utilizing cache resource more efficiently based on cache miss rate prediction and monitoring the MSHR entries. According to our experimental results, reservation fail cycles can be reduced by 25.7% and IPC is increased by 6.2% with the proposed scheduling technique compared to loose round robin scheduler.