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Park Sang Won,Yeo Na Young,Kang Seonguk,Ha Taejun,Kim Tae-Hoon,Lee DooHee,Kim Dowon,Choi Seheon,Kim Minkyu,Lee DongHoon,Kim DoHyeon,Kim Woo Jin,Lee Seung-Joon,Heo Yeon-Jeong,Moon Da Hye,Han Seon-Sook 대한의학회 2024 Journal of Korean medical science Vol.39 No.5
Background: Worldwide, sepsis is the leading cause of death in hospitals. If mortality rates in patients with sepsis can be predicted early, medical resources can be allocated efficiently. We constructed machine learning (ML) models to predict the mortality of patients with sepsis in a hospital emergency department. Methods: This study prospectively collected nationwide data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Patients were enrolled from 19 hospitals between September 2019 and December 2020. For acquired data from 3,657 survivors and 1,455 deaths, six ML models (logistic regression, support vector machine, random forest, extreme gradient boosting [XGBoost], light gradient boosting machine, and categorical boosting [CatBoost]) were constructed using fivefold cross-validation to predict mortality. Through these models, 44 clinical variables measured on the day of admission were compared with six sequential organ failure assessment (SOFA) components (PaO2/FIO2 [PF], platelets (PLT), bilirubin, cardiovascular, Glasgow Coma Scale score, and creatinine). The confidence interval (CI) was obtained by performing 10,000 repeated measurements via random sampling of the test dataset. All results were explained and interpreted using Shapley’s additive explanations (SHAP). Results: Of the 5,112 participants, CatBoost exhibited the highest area under the curve (AUC) of 0.800 (95% CI, 0.756–0.840) using clinical variables. Using the SOFA components for the same patient, XGBoost exhibited the highest AUC of 0.678 (95% CI, 0.626–0.730). As interpreted by SHAP, albumin, lactate, blood urea nitrogen, and international normalization ratio were determined to significantly affect the results. Additionally, PF and PLTs in the SOFA component significantly influenced the prediction results. Conclusion: Newly established ML-based models achieved good prediction of mortality in patients with sepsis. Using several clinical variables acquired at the baseline can provide more accurate results for early predictions than using SOFA components. Additionally, the impact of each variable was identified.
Kim, Youngil,Kang, Sinkyu,Lim, Jong‐,Hwan,Lee, Dowon,Kim, Joon Springer Japan 2010 Ecological research Vol.25 No.4
<P><B>Abstract</B></P><P>This study aims to evaluate inter‐annual and inter‐plot variation of wood biomass production (WBP) and to investigate the relationships of the WBP variations with several biotic and abiotic characteristics at a deciduous forest in complex terrain, the Gwangneung Experimental Forest, Korea. Based on field survey in the plot‐scale study area, WBP during 1991–2004 was estimated by a dendrochronological method. Our field data indicated that the inter‐annual variation of WBP was closely related to the seasonal climate of both winter air temperature and spring precipitation. The inter‐plot variation of WBP was highly associated with basal area, biomass, and frequency of <I>Quercus</I> spp. in the plots, and correlations of the inter‐plot variation with the stand characteristics of the specific species were stronger than those with slope and soil water content. Our results suggest that the annual fluctuation of forest productivity is primarily governed by severe climate in a season of the year, and the spatial distribution of a dominant species largely represent plot variation in the productivity. Our findings contribute to an enhanced understanding of climatic effects on the annual variability of forest productivity and the spatial heterogeneity of the productivity, which are extensively concerned with forested ecosystems of Korea.</P>
A rare case of nerve compression caused by a connected lipoma of the wrist
DoWon Kim,JungSoo Yoon,SuRak Eo,YeaSik Han,SooA Lim 대한수부외과학회 2023 대한수부외과학회지 Vol.28 No.1
A variety of benign and malignant neoplasms can develop in the hand, originating from skin, adipose tissue, tendons, muscles, nerves, and bones. However, most cases are benign; therefore, observation is recommended if they are small, painless and do not cause limitation of motion. When symptoms are present or a lesion is larger than 5 cm in the long axis, an excisional biopsy is required to relieve symptoms and exclude malignancy. Lipomas of the hand are quite rare and do not generally cause symptoms. Lipomas of the hand that do present with symptoms are usually giant (larger than 5 cm in diameter) or located in a deeper layer, compressing the nearby nerves and vessels. We report a rare case of a non-giant superficial lipoma of the wrist that resembled two separate masses and caused pain, limitation of motion, and neurological symptoms.
DoWon Kim,JungSoo Yoon,SooA Lim,YeaSik Han,SuRak Eo 대한수부외과학회 2023 대한수부외과학회지 Vol.28 No.1
Pediatric trigger finger (PTF) is a rare hand disorder caused by various anatomic abnormalities and systemic illnesses. We report a case of PTF in a 16-month-old boy, revealing a flexion deformity of his right middle finger. We noted an abnormally proximal location of Camper’s chiasm and bulging of the flexor digitorum profundus intraoperatively. We released the A1 pulley completely and resected an ulnar slip of the flexor digitorum superficialis (FDS). The short-term outcome was satisfactory; however, the patient experienced a mild flexion deformity and ulnar deviation of the right middle finger at a 4-year follow-up visit. During reexploration, we noted severe scar adhesion along the previously cut end of the ulnar slip of the FDS. Therefore, we performed en-bloc scar tissue release with additional resection of the remaining radial slip of the FDS. To prevent recurrence after PTF release, close monitoring with short-term follow-up and early physiotherapy should be emphasized.
Political rents, elections, and in-kind transfers:Theory and empirical evidence
Dowon Kim,ongwon Lee,angwon Park 한국재정학회 2017 한국재정학회 학술대회 논문집 Vol.2017 No.-
This study examines the claim that political rent-seeking promotes excessive in-kind transfers. Our analysis suggests that: (1) a government seeking political rents would substitute in-kind transfers for cash transfers and (2) this substitution effect is weakened at the end of the election term because the incumbent would shift the composition of transfers towards cash payments in order to secure reelection. Data taken from OECD countries for 25 years support the hypotheses. In particular, we find that the pre-electoral effect is more significant in established democracies where voters are well informed about electoral politics. The findings of this paper imply that the interactions between political rent-seeking and reelection constraints markedly influence the composition of social transfers.