HL7기반 노인장기요양보험 등급판정시스템 모형 개발

Objectives: The purposes of this study were to develop the HL7-based Classification System for the Long Term Care Insurance for the elderly in order to reduce classification errors and to reduce variations in classification among rating doctors. Specifically, the classification system was developed for the elderly who were eligible for the Long Term Care Insurance based on HL7 standards and eligibility criteria developed by the National Health Insurance Cooperative (NHIC). Methods: 38 cases that were actually reviewed by rating committee in May 2009 were selected from the classification data submitted to the long term care insurance unit at the D branch of NHIC on HL7. The system was designed by selecting 46 items from health insurance and NHIC criteria and IPI(Insurance Patient Information) message based on HL7 2.5 in order to transmit messages to other institutes. The system was analyzed and designed by DFD(Data Flow Diagram) and HIPO(Hierarchical Input, Process, Output). The system was evaluated through frequency analysis of system environment and rating data after calculating the 2nd grade by operating each module of HL7 message. Results: The results of this research were as follows: 38 cases submitted by doctors were 22 right cases and 16 wrong cases for the physical condition area; 27 right cases and 11 wrong cases in the area of mental state; and 26 right cases and 12 wrong cases in the area of independence of daily life. The number of cases whose grade was changed was 4: 1 case from 4th grade to 3rd grade, 2 cases from 3rd grade to 2nd grade and 1 case from 2nd grade to 1st grade. The cause of functional disorder for changing grade was 3 dementia and 1 bleeding. Conclusions: The model of the HL7-based Classification System for the Long Term Care Insurance for the elderly was designed to reduce classification errors and to reduce variations in classification among rating doctors. After the use of the model system, its usability was assessed.ope

Evaluation of CDSS for Drug Prescriptions Based on Success Measures.

OBJECTIVE: The Clinical Decision Support System (CDSS) for drug prescriptions was developed by integrating the computerized physician order entry (CPOE) system to support doctors and pharmacists in making correct decisions on prescribing drugs in line with the prescription guidelines by the Health Insurance Review Agency (HIRA). The objective of this study was to evaluate the performance of the CDSS with respect to system quality, information quality, and user satisfaction in reducing prescription errors. METHODS: The study was based on survey data from 38 hospitals that were using the CDSS for drug prescriptions. To identify factors influencing the performance of CDSS, multiple linear regression and chi-square analyses were performed. RESULTS: Regression analysis showed that the variables for system quality and information quality significantly influenced the overall system performance. Specifically, ease of understanding the results and terminology assystem quality measures significantly influenced user satisfaction. Furthermore, based on chi-square analysis, two independent variables (ease of understanding results and decision support functions) were statistically significant with respect to all four dependent variables (information satisfaction, system satisfaction, willingness to recommend to other hospitals, and drug safety). CONCLUSION: Based on this study, users should be educated to improve their understanding of the system,and system and information quality should be continuously monitored to improve user satisfactionope

A Stndy on the Intes t in a liza tion"

the stomach. It has been recognized since 1883 by Kiipffer. Its orgin and significance have been still not clearly understood. Two hypothesis have been proposed for the origin of intestinal type epithelium in the stomach. One suggests that the intestinal epithelium results from heterotopic tissue present at birth due to a residual embryonal cell or tissues. These cells or tissues differentiate and/or proliferate with disease (heterot• opia)6,52 ,58,78) The second theory, the more widely held, that the mucosal tissue is regenerated and/or differentiated to the intestinal epithelium as a result of chronic irritations which are not as a congenital one but acquired (metaplasia). The chraceteristics of intestinal elements in the stomach lining are 1) columnar cells, with a striated border on their free surface. 2) goblet cells , and 3) Paneth cells and/or argentaffin cells. The aberrent intestinal epithelium has been observed r in chronic inflammatory conditl6ns, peptic ulcer , carcinoma of stomach, polyp and other exert a destructive effect upon the gastric mucosa by many authors" 52,78. 88 2G. '0, G) It has been considered to be a premalignant conditions" 31. 52 ,78). This view is supported by the presence of metaplastic component such as striated cell borders'!) or enzyme characteristic of intestinal epithelium"). The other hand, its view is denied by some authors!5, GO) Recent electron microscopic studies have shown the abberrent epithelium to be identical in fine structure and histological arrangement with normal jejunal epithelium63 • 67) . In this aspect, like normal jejunal epithlium, the intestinalized gastric epithelium is able to transport dietary and micellar lipid from the bowel lumen into the adjacent lamina propria, in this manner more lipid can be detected in metaplastic epitheliumGG). Some authors induced the intestinal epithelium in the gastric mucosa experimentally by dietary carcinogen7), histamin8), toxic substance'G) or sclerosing compoundG). The frequency of intestinalization is various record in 11 to 100 per cent of the stomach specimen e~;amined. The author tried to recogniz of intestinalization of Korean adults by resected specimens on the view of relationships between the various gastric disease and metaplasia on clinical and pathological aspects. Following were the results: 1) In 50 cases of control stomachs obtained by autopsy in the present study, the following data were obtained. The intestinal metaplasia was recognized in 3 cases (6% ), of which 2 were combined with gastritis The fat droplet could not found in any cases. Mucosal atrophy was found in 3 cases and lymph follicle was 2 cases out of 6 cases with gastritis of autopsy specimens. 2) Intestinalization was found in the gastric mucosa in 193 cases (49.7%) out of 3S9 resected stomach group. 3) The greatest frequency of intestinal metaplasia was in the carcinoma of the stomach 56% followed by stomach ulcer 53%, polyp 50%. gastritis 38%

ARX와 SVM을 이용한 비선형 시스템 모델링에 관한 연구

Maste

LC/MS Data Analysis using Peak Clustering

Maste

수중 음향 트랜스듀서 구동을 위한 능동 소나 송신기의 출력 보상 기법에 관한 연구

Doctor수중 음향 배열 트랜스듀서의 임피던스 변동 조건에서 능동 소나 시스템의 음원 준위를 극대화하도록 소나 송신기의 설계가 필요하다. 송신기는 다채널의 트랜스듀서를 개별 구동하고, 다양한 송신신호와 송신빔을 구동한다. 그러한 이유로, 배열 트랜스듀서의 임피던스 분포는 커지게 되지만, 실제 소나 시스템에서는 이를 구동하는 송신기의 정격 전력이 제한된다. 본 논문은 임피던스 변동 조건에서 요구된 지향 방위로 고출력 송신하기 위한 송신기의 효과적이고 안정적인 출력 제어 기법을 제안한다. 제안된 제어 기법이 적용될 송신기 설계에 위하여, 트랜스듀서의 전기적 등가 모델링과 임피던스 정합 및 필터 회로를 설계한다. 등가모델링에서는 PSO 알고리즘 기반의 추정 방법과 공기중 및 수중에서의 데이터를 이용하여 추정 오차를 최소화하는 적합도 함수를 적용한다. 정합 회로는 실제 시스템을 고려하여 구동에 불필요한 무효 전력과 정합 트랜스포머의 자화 인덕턴스를 최소화하는 설계 파라미터들을 추정하도록 설계된다. 또한, 필터 회로는 트랜스듀서의 정합 회로와 등가 회로 소자들을 고려하여 출력 신호의 고조파 성분을 줄이도록 설계된다. 제안된 제어 기법과 관련하여, 임피던스 변동 부하를 구동하기 위한 정전력 및 정전압 제어와 순간 전압 및 전류 제어 기법들을 제안한다. 송신기의 출력 전력 및 전압은 임피던스 변동 조건에 따라 PWM 신호의 변조 지수 변화를 통해 제어된다. 제안된 제어 기법들은 모의부하와 실제 배열 트랜스듀서를 통해 검증된다. 송신빔 형성 정확도에 영향을 주는 위상 지연 오차를 보상하기 위하여, 위상 지연 제어 기법을 제안하고 부하 조건에 따른 시뮬레이션을 통해 적용 가능성을 확인하였다.In the active sonar system, a study of the transmitter is required for maximizing the acoustic source level. For driving acoustic transducer array, the transmitter could individually drive multi-channel transducers for generating various signal types and beams. In the condition, the impedance distribution of the transducer array becomes large, and the power rating of the transmitter also increases for covering the impedance range. But the power and voltage of the transmitter are limited in the real sonar system. This thesis proposes the effective and stable output control methods of the transmitter for high power transmission toward a desired direction in the variable impedance condition. Before applying the proposed control method to the transmitter, design works which consists of the electrical equivalent modeling of the transducer, the design of the impedance matching, and the filter circuit are performed. In the equivalent circuit modeling, an estimation method based on PSO (particle swarm optimization) algorithm and a fitness function, are used for minimizing the estimation errors by utilizing the measured data in air and water. The matching circuit is designed to estimate the design parameters for minimizing the unnecessary reactive power and magnetizing inductance of the matching transformer. The filter circuit is designed to reduce the harmonics of the output signal considering the matching circuit and the equivalent circuit of the transducer. In the control, two methods are proposed for driving the variable impedance loads. One is the constant power & voltage control, and another is the instant voltage & current control method. The output power and voltage of the transmitter are controlled by changing the modulation index of PWM (pulse width modulation) according to the variable impedance conditions. The proposed control methods are verified by using a simulated load and real transducer array. To compensate the phase delay errors affecting the beamforming accuracy, the phase delay control method is proposed and is verified through the simulation according to the load conditions. As a result, the proposed controls can compensate the output power and the phase delay error caused by individually driving the transducer array

Prediction of congestion sites in Pohang

1

상관있는 폭발적 동역학의 생성 모형 및 방법

DoctorIn various natural and social phenomena, temporal inhomogeneities have been observed. The events such as earthquakes, single neuron firings, solar flares, and human communications occur rapidly within short time periods and sparsely within long time periods. These phenomena is called bursts, primarily characterized in terms of scaling behaviors in the autocorrelation function with a decaying exponent $\gamma$, the interevent time distribution with a power-law exponent $\alpha$, and the burst size distributions. Here the interevent time is defined as a time interval between two consecutive events in the event sequence, and the burst size denotes the number of events in a bursty train detected for a given time window. In order to understand such temporal scaling behaviors implying a hierarchical temporal structure, we devise a hierarchical burst model by assuming that each observed event might be a consequence of the multi-level causal or decision-making process. By studying our model analytically and numerically, we confirm the scaling relation $\alpha+\gamma=2$, established for the uncorrelated interevent times, despite of the existence of correlations between interevent times. Such correlations between interevent times are supported by the stretched exponential burst size distributions, for which we provide an analytic argument. In addition, by imposing conditions for the ordering of events, we observe an additional feature of log-periodic behavior in the autocorrelation function. Our generative modeling approach for the hierarchical temporal structure can help us better understand the underlying mechanisms behind complex bursty dynamics showing temporal scaling behaviors. After the generative modeling approach, we consider the generative method for correlated bursty dynamics. The memory coefficient is a measure for detecting the first order correlations between two consecutive interevent times. The conditional method is for generating single event sequences with controllable interevent time distribution and memory coefficient independently. Before our method, there are two different generative method: an annealing method and Gillespie method. Comparing the existing methods, the conditional method has advantage that we can control the correlations between interevent times directly through tuning the memory coefficient. When the memory coefficient is given as a parameter, we can uniquely determine the joint probability distribution under the condition of the proper upper bound for the memory coefficient. After calculating the joint probability distribution function and consequently the conditional cumulative distribution function, the interevent times are drawn from the inverse of the conditional cumulative distribution function under the condition that the previous interevent time is given. By repeating calculation of the conditional cumulative distribution function, we can obtain the ordered set of the interevent times with desirable memory coefficient. Here, we suggest the conditional method for two typical distribution functions: an exponential and a power-law distribution. Our generative method for single event sequences can help us better understand the efficient methodology for producing the correlated bursts.본 논문은 상관있는 폭발적인 동역학을 이해하기 위해 사건 간 시간 간격 분포가 상관관계를 갖는 생성적인 계층 모델을 구축하고, 주어진 기억계수와 사건 간 시간 간격 분포를 갖는 단일 사건 순서열을 생성하는 조건 방법론을 제시하였다. 전화 통화, 문자 메시지, 전자 메일 등 사람 사이의 커뮤니케이션 및 태양의 플레어, 지진, 그리고 단일 뉴런의 발화에 이르기까지 많은 자연 현상에서 버스트 현상이 발견되었다. 버스트는 사건이 폭발적으로 발생하는 시기와 사건이 거의 발생하지 않는 시기가 번갈아가며 나타나는 현상이다. 이로 인해 버스트 현상에서는 사건 간 시간 간격 분포가 멱함수를 따른다. 이때 중요한 것은 시간 간격 사이의 상관성인데, 특정 문턱값으로부터 얻어진 버스트 트레인 안의 사건의 개수의 분포인 버스트 크기 분포로 상관관계를 알 수 있다. 만약 버스트 분포가 지수함수에서 벗어난 꼴이라면 상관성이 있다고 볼 수 있다. 실제 사건들이 계층적인 구조를 갖고 있다는 여러 증거 하에 계층적인 모델을 구축하여 상관성이 있는 버스트 사건 순서열을 얻었다. 이때 사건 사이에는 프랙탈 구조를 가지며, 멱함수 시간 간격 분포와 자기상관함수를 얻었고 각각의 계수인 $\alpha$와 $\gamma$ 사이에 $\alpha+\gamma=2$라는 스케일링 관계가 성립함을 수치적으로 밝혔다. 버스트 분포는 늘어난 지수함수로서 멱함수와 다른 분포를 얻었는데, 이를 설명하기 위해 수학적인 계산을 수행하여 멱함수 수준의 두꺼운 꼬리가 나타나지 않는 이유를 두 경우의 확률 값을 비교하여 설명하였다. 앞서 언급한 스케일링 관계는 시간 간격 사이의 상관관계가 없을 때 이론적으로 성립하는데, 늘어난 지수함수의 버스트 분포를 갖는 사건 순서열에서도 마찬가지로 스케일링 관계가 성립함을 밝혔다. 또한 주어진 모델을 변형하여 많은 경우를 살펴보았다. 먼저 모델의 각 층위에서 사건의 사이의 교차가 있는 경우도 이를 허용하지 않는 경우와 같은 결과가 나옴을 보였다. 이때 계층 모델의 특성 상 자기상관함수가 로그 주기성을 가짐을 확인하였다. 매 단계마다 사건의 수가 두 배가 아닌 세 배와 네 배가 되는 경우, 방향성이 없는 경우, 마지막 층위의 사건 뿐 아니라 모든 층위의 사건을 고려하는 경우도 같은 결과를 얻으므로, 본 모델이 다양한 변형 방법에도 성립함을 보였다. 이 연구를 통해 시간적으로 스케일링 특성을 갖는 기작을 만드는 시간적인 구조의 이해에 기여를 할 수 있을 것이라 기대한다. 다음으로 상관있는 폭발성을 갖는 단일 사건 순서열을 만드는, 조건 방법론이라는 생성 방법론을 제시하였다. 기억계수는 연속된 두 시간 간격 사이의 피어슨 상관계수로서 시간적인 상관관계 측정에 널리 쓰이고 있다. 조건 방법론을 통해 기억계수가 주어질 때 원하는 사건 간 시간 간격 분포를 갖는 단일 사건 순서열을 만드는 방법을 제시하였다. 기억계수가 주어지면 결합확률분포가 유일하게 결정되는데, 이때 기억계수의 값은 작아야 한다. 조건부 누적확률의 역함수 값을 통해 순차적으로 특정한 시간 간격 분포를 갖는 시간 간격들을 얻을 수 있고, 이를 통해 주어진 기억계수를 갖는 단일 사건 순서열을 구축할 수 있다. 여기에서는 두 가지 대표적인 분포인 지수함수와 멱함수에 대해서 조건 방법론을 제시하였다. 이 연구를 통해 기존의 방법론에 더해 상관있는 폭발성을 만드는 방법론 개발에 기여를 할 수 있다. 계층적인 생성 모형 제시 및 분석과 생성 방법론 제시를 통해 상관있는 폭발적인 동역학의 이해가 깊어질 것이라 기대한다

Competency-based learning program in system analysis and design for health professionals

This study aims to evaluate the effectiveness of a competency-based learning (CBL) approach to an e-learning course on systems analysis and design (SAD). The competency of 18 students who registered for an SAD course was measured at different 3 times during the semester with the use of a competency diary. The changes in the competency scores through the semester were analyzed by a Friedman test, and the factors affecting learning effectiveness were identified by multiple regression. The competency scores increased as the semester progressed. The factors that had a significant effect on learning effectiveness were course management and learning materials. The authors found that the CBL approach worked well for this particular e-learning course on SAD and that nontechnical aspects of the instruction, such as course management and lecture materials, were more important than the technical aspects even in this Internet environment.ope