Co-evolution of an emerging mobile technology and mobile services : a study of the distributed governance of technological innovation through the case of WiBro in South Korea

This thesis is a study of the development and uptake of an emerging infrastructural technology: the mobile Wireless Broadband technology and service known as WiBro in South Korea, and Mobile WiMAX internationally. WiBro has emerged through a national development effort since the early 2000s. The commercial service was launched in 2006. However, uptake fell far below initial expectations, only succeeding in niche markets. This study was motivated by concerns about the perceived gulf between development and diffusion and the ‘failure’ of WiBro. However, this study seeks to go beyond the technology-driven perspective that informs conceptions of diffusion gap: it aims to explicate the sociotechnical factors leading to such a gap. This study draws on Science and Technology Studies (STS) and in particular the Social Shaping of Technology (SST) perspective, which provides tools to scrutinize the interactions among the various interests and factors involved in the process of technological innovation. The SST perspective goes beyond approaches that treat technology as a static object to be developed and diffused. It provides tools to examine the complex and dynamic forces that develop technical capacity towards particular forms and uses. The ‘social learning’ perspective extends SST and provides concepts to explore the changing dynamics over multiple cycles of innovation. Here, Jørgensen’s concept of ‘development arena’ helps examine the interlinked, yet dispersed and multiple spaces in which differing goals, motivations and strategies of innovation players together shape technological innovation. Through comprehensive analyses of a longitudinal study of WiBro, a broader view of the process and the outcomes of technological innovation have been achieved. Rather than viewing the technology as a stable object that would progress in a linear manner through the stages of design, development, and diffusion, it has focused on the process of shaping of WiBro through multiple cycles of innovation. Several arenas of innovation were identified as diverse players sought to align their interests towards exploiting the resources, capacities, and tools for innovation that seemed to be available. In these spaces, conflicting and yet coevolving dynamics were observed: one involving coordination through alignments of multiple interests, and the other incorporating tensions and misalignments among the differing concerns, aims and commitments towards the innovation. The complex dynamics involved a multi-level game where the collective actions among the innovation players and their individual strategies diverged to a degree. Furthermore, changing contingencies, linked to shifting choices of innovation players, resulted in the deviation of the innovation from the initial visions and aims. The study thus illustrates the outcomes of highly divergent interactions at play in innovation process and the mutual enrollment efforts of players that constituted the distributed governance of innovation. Here the complex interplays among the innovation players involved in multi-level games produced a gap between the generic vision and the actual uptake of WiBro. Changing contingencies, especially linked to broader and evolving structures and relations - brought about the reshaping of the generic vision of WiBro. This research therefore suggests the concept of the ‘distributed governance of innovation’ as a new mode for governance: that accommodates not only differing knowledges and interests but also the shifting choices and visions through the various cycles of technological innovation. The boundary of social learning is thus extended to incorporate diverging choices over time and across the multiple spaces of innovation. Its implications for policy include achieving reflexivity by incorporating into the policy framework the learning process that takes place as the innovation players go through the varying stages and cycles of technological innovation

Cessation of Gonadotropin-Releasing Hormone Antagonist on Triggering Day: An Alternative Method for Flexible Multiple-Dose Protocol

This study was performed to analyze retrospectively outcomes of stimulated in vitro fertilization (IVF) cycles where the gonadotropin-releasing hormone (GnRH) antagonist was omitted on ovulation triggering day. A total of 92 consecutive IVF cycles were included in 65 women who are undergoing ovarian stimulation with recombinant FSH. A GnRH antagonist, cetrorelix 0.25 mg/day, was started when leading follicle reached 14 mm in diameter until the day of hCG administration (Group A, 66 cycles) or until the day before hCG administration (Group B, 26 cycles). The duration of ovarian stimulation, total dose of gonadotropins, serum estradiol levels on hCG administration day, and the number of oocytes retrieved were not significantly different between the two groups. The total dose of GnRH antagonist was significantly lower in Group B compared to Group A (2.7±0.8 vs. 3.2±0.9 ampoules). There was no premature luteinization in the subjects. The proportion of mature oocytes (71.4% vs. 61.7%) and fertilization rate of mature (86.3±19.7% vs. 71.8±31.7%) was significantly higher in Group B. There were no significant differences in embryo quality and clinical pregnancy rates. Our results suggest that cessation of the GnRH antagonist on the day of hCG administration during a flexible multiple-dose protocol could reduce the total dose of GnRH antagonist without compromising IVF results

Hysteroscopic Resection of the Vaginal Septum in Uterus Didelphys with Obstructed Hemivagina: A Case Report

Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Excision of the obstructed vaginal septum is the treatment of choice for symptom relief and the preservation of reproductive capability. A 14-yr-old girl complained of persistent vaginal spotting following each menstruation. Pelvic magnetic resonance imaging revealed a uterus didelphys with left hematocolpos and ipsilateral renal agenesis. Instead of conventional transvaginal excision of the vaginal septum, we used hysteroscopic excision under transabdominal ultrasonographic guidance to preserve the integrity of the hymen. The postoperative course was uneventful, and clinical symptoms were completely resolved after this intervention. Resectoscopic excision of the vaginal septum was found to be easy, safe, effective, and appropriate for young women as it preserved hymen integrity. We believe that this is the first Korean report on the use of a hysteroscopy for vaginal septum resection in a patient with uterus didelphys with obstructed hemivagina

Use of Intravenous Immunoglobulin in the Treatment of Childhood Atopic Dermatitis

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Pregnancy outcomes of different methods for multifetal pregnancy reduction: a comparative study

The purpose of this study was to evaluate the outcomes of various methods of multifetal pregnancy reduction (MFPR) and to determine which method produces better outcomes. One hundred and forty-eight patients with multiple pregnancies resulting from assisted reproduction programs and underwent MFPR were included. According to the use of potassium chloride (KCl), patients were divided into 'KCl', and 'non- KCl' groups, and based on gestational age at the time of procedures, patients were divided into 'Early' (before 8 weeks of gestation) and 'Late' (at 8 weeks or later) groups. Firstly, to clarify the effect of each component of MFPR procedure, data were analyzed between 'KCl' and 'non-KCl' groups, and between 'Early' and 'Late' groups with adjustments. Secondly, comparison between 'Early, non-KCl' and 'Late, KCl' groups was performed to evaluate the combinative effect of both components. Non-KCl groups showed a significantly higher take-home-baby rate, and lower risk of extreme prematurity and preterm premature rupture of membranes (PPROM) than KCl groups. Early groups showed a lower immediate loss rate than Late groups. As compared with 'Late, KCl' group, 'Early, non-KCl' group was superior in terms of immediate loss, pregnancy loss, take-home-baby, and PPROM rates. Our data suggest that the 'early, non-KCl' method may be a better option for MFPR

Implications of helplessness in depression: diagnosing mild cognitive impairment and analyzing its effects on cognitive decline in older adults

BackgroundThis study focuses on how elements of depression correlate with mild cognitive impairment (MCI) in older adults and the diagnostic efficacy of combining these components with the Mini-Mental State Examination (MMSE). The study also investigated the connection between individual depression components and overall cognitive function, as measured by the total score (TS) of the consortium to establish a registry for Alzheimer’s disease (AD) assessment battery.MethodsThe study included 196 nondemented adults aged 65 to 90 years at a university hospital and community. Comprehensive clinical assessments including the 30-item Geriatric Depression Scale (GDS) to measure components of depressive symptoms, TS, and blood nutritional biomarkers.ResultsOur stepwise logistic regression analysis highlighted the ‘helplessness item’ (odds ratio = 4.531, 95% CI = 2.218 to 9.258, p < 0.001) as a significant predictor for MCI diagnosis. Further, models incorporating ‘helplessness item + MMSE’ demonstrated markedly enhanced accuracy in diagnosing MCI, surpassing the performance of the MMSE used independently. Notably, the group characterized by helplessness showed a significant reduction in TS (B = −5.300, SE = 1.899, β = −0.162, p = 0.006), with this trend being particularly pronounced in individuals exhibiting lower levels of physical activity. Interestingly, this correlation did not manifest in participants with higher physical activity levels.ConclusionOur findings suggest that helplessness is highly effective in diagnosing MCI and is linked to a decrease in cognitive function. Therefore, when addressing MCI and AD-related cognitive decline, clinicians should consider helplessness