병원급 의료기관에 따른 임상영양서비스에 대한 전국적 실태 조사

엄미향 경희대학교 동서의학대학원 2016 국내박사

Clinical Nutrition Service in Long Term Care Hospital By Mi Hyang Um Doctor of Philosophy in Medical Nutrition Graduate School of East-West Medical Science Advised by Dr. Yoo Kyoung Park The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. Hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospitals and 223 dietitians completed the survey of clinical nutrition services and job satisfaction questionnaires. The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. The results of this study are as follows. The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. Korea Institute for Healthcare Accreditation (KOIHA) accredited hospitals showed only 50% performance rate of nutrition service evaluation area. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. This shows that after achieving KOIHA accreditation, many hospitals do not emphasize the performance of nutritional services. Key words Long term care hospital, Clinical nutrition service, Korea Institute for Healthcare Accreditation (KOIHA), Job satisfaction levels Clinical Nutrition Service in Tertiary Hospital By Mi Hyang Um Doctor of Philosophy in Medical Nutrition Graduate School of East-West Medical Science Advised by Dr. Yoo Kyoung Park Starting from the year of 2007, a total of 29 hospitals in South Korea had received accreditation from JCI (Joint Commission International). Difference in the status of clinical nutrition service provision was compared between JCI accredited tertiary hospitals and non-accredited hospitals. General facility questionnaire and nutrition service questions were asked to JCI accredited tertiary hospitals and non-JCI accredited tertiary hospitals. Job satisfaction of clinical dietitians was collected from all 43 tertiary hospitals in South Korea. A total of 35 sets of clinical nutrition service survey and 234 sets of clinical dietitian job satisfaction survey was analyzed. The clinical nutrition service questionnaire items were largely divided into two categories of characteristics of hospital and provision of clinical nutrition task. Characteristics of hospital status was comprised of general work related to the hospital and nutrition department, while clinical nutrition task status was comprised of questions on nutrition management of inpatients, inpatient malnutrition status for one month, and post-management issues related to malnourished patients. The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. The results of this study are as follows. JCI accredited tertiary hospitals (N=8) showed higher, but not significantly higher, nutritional intervention rate of 12.7% on malnourished patients, compared to 7.0% in non-JCI accredited tertiary hospitals (N=27). In clinical dietitian job satisfaction, JCI accredited tertiary hospitals showed lower job satisfaction scores for job security and wages than non-JCI accredited tertiary hospitals, whereas they showed higher job satisfaction scores in pride as a clinical dietitian and occupational assessment (P<0.05). The areas of improvement for promotion of clinical nutrition service in South Korea, as shown from the top-tier hospitals surveyed, were lack of manpower (1st) and communication with medical staff (2nd). Accreditation from JCI has shown a positive influence in advancement of not only the hospital service, but also, in the area of clinical nutrition service. However, because of the overall shortage of manpower, decision makers need to develop new strategy to prevent decline in the quality of clinical nutrition service. Keywords Clinical nutrition service, Clinical dietitian, Joint Commission International (JCI) accreditation, Tertiary Hospital. Clinical Nutrition Service in General Hospital By Mi Hyang Um Doctor of Philosophy in Medical Nutrition Graduate School of East-West Medical Science Advised by Dr. Yoo Kyoung Park The purpose of this study was to investigate the status of clinical nutrition services provided at general hospitals in Korea, and to investigate job satisfaction levels of the clinical dietitians. Survey questionnaire was sent to dietitians working at a general hospital. Hospitals (n=114) were randomly selected from 280 general hospitals using a stratified sampling method. A total of 64 general hospitals and 183 dietitians completed the survey of clinical nutrition services and job satisfaction questionnaires. The clinical nutrition service questionnaire items were largely divided into two categories of characteristics of hospital and provision of clinical nutrition task. Characteristics of hospital status was comprised of general work related to the hospital and nutrition department, while clinical nutrition task status was comprised of questions on nutrition management of inpatients, inpatient malnutrition status for one month, and post-management issues related to malnourished patients. The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. The results of this study are as follows. Among the general hospitals surveyed (n=64), fifty had the large-sized general hospitals (>300 beds). The average number of beds was 481 and average length of stay (LOS) was 9 days. Dietitians had 8 years of career experience, on average. 14.3% (n=2) of the medium-sized general hospitals (100-300 beds) were Korea Institute for Healthcare Accreditation (KOIHA) accredited, while 64% (n=32) of the large-sized general hospitals (n=50) were KOIHA accredited. The rate of computerized nutritional screening was 35.7% in the medium-sized general hospitals but 82.0% in the large-sized general hospitals (p<0.01). According to KOIHA accreditation, nutrition screening rate, malnutrition detection rate and nutritional intervention rate were indicating a slight implementation rate, but not a significant difference. On the other hand, according to beds, in the medium-sized general hospitals showed the lowest performance rate of nutritional care, but not a significant difference. Nutrition support team (NST) actively operating was 14.3% (n=2), in less than general hospitals and 58.0% (n=29), in more than general hospitals which indicated a higher NST actively operating rate (p<0.01) according to beds (100-300 beds vs >300 beds). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between general hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care. Key words Korea Institute for Healthcare Accreditation (KOIHA) accredited, Clinical nutrition service, Medium-sized general hospitals, Large-sized general hospitals.  

Physicochemical, biological and pharmacokinetic characterization of a biosimilar anti-Her2 monoclonal antibody

Yoo, Wonyoung Sungkyunkwan University 2014 국내박사

Cumulative energy analysis of surface wrinkling on multilayered thin film

Yoo, Seongsoo Sungkyunkwan university 2018 국내석사

Surface wrinkling can be observed widely in nature or daily life, and this phenomena has been generally known to be occurred when compressive stress exceeds the critical stress of wrinkling. To elucidate this well-known phenomena, there have been a number of studies on interpretation of instability and corresponding mechanism of wrinkling on bilayered or multilayered film. Most of previous studies on analysis of multilayer wrinkling explain with force balance equation where thickness of substrate is negligible. However, this approach is invalid for wrinkling on multilayer deposited on non-deformable rigid support, because, in this case, wrinkling behavior depends on thickness of each constituting layers. Therefore, other analysis of multilayer wrinkling that reflect the thickness effect of substrate is required. To response this requirement, in this study, we extended free energy analysis that is employed to analyze bilayer wrinkling with considering thickness effect of substrate to wrinkling on multilayer. As a result, wavelength equations for wrinkling on multilayer film which matches well the experimental results was derived. In addition, derived equation can be employed as calculation toolkit of metrology which can estimate Young’s modulus of unknown thin film in simple way.

Studies on enhancing electrochemical and optical properties of multilayered nanomaterials by controlling nanoarchitecture

Yoo, Seongsoo Sungkyunkwan University 2022 국내박사

Nanotechnologies has led to the great development of modern science and engineering due to advantages of nanomaterials such as unique optical properties, outstanding physical properties, or large specific surface area. In this process, tremendous of nanostructures have been studied. Typically, the multilayered structures have been developed in nanoscale and utilized in many fields including industries and real life, because multilayer structure facilitate to integrate all intrinsic properties of layer and resulting synergetic effect. As a result, the performance of devices employing the multilayered nanomaterials have been improved by advantage of nanomaterials, and, in line with this trend, the researches on miniaturization of such a multilayered structure is still receiving a lot of attention. Since the current technologies controlling multilayered nanostructures has advanced enough to control it at the level of several tens of nm, to further enhance, the technique that can control nanoarchitecture precisely is required in sub-10 nm scale. However, it is quite difficult to control in sub-10 nm structure with applying conventional technologies such as photolithography. Even though bottom-up based assembly process using nanosheets or nanoparticles can fabricate the sub-10 nm structure, it is also challenge to precisely control in this level. Considering that the few nm changes result in large changes in properties of nanomaterials, the precise control of nanoarchitecture is essential for current nano-engineering field. To address this point, in this dissertation, we demonstrate the techniques that can control nanoarchitecture on the order of several nm or even order of angstrom using surface modification which adjusts steric hindrance or surface charge of nanosheets or nanoparticles. In chapter 2, we present the control of inter-sheet distance between graphene oxide nanosheets by surface modification of graphene oxide nanosheets with octadecyl amine molecules that generate steric hindrance. The inter-sheets distance is controlled at the angstrom level in the range of 1-2.4 nm. In addition, we show that the enlargement of electroactive surface area can be achieved by controlling inter-sheet distance and ensuing improvement of electrochemical properties of materials. In chapter 3, we explained technology applied to MXene-blanketed gold nanoparticles (AuNPs) array, which control the gap distance of AuNPs and bending structures of MXene nanosheets by modifying stabilizer to amine-(polyethyleneglycol)-thiol (HS-PEG-NH2) from long chain polymer such as polyDADMAC. Since the HS-PEG-NH2 increase the surface charge and reduce steric hindrance, the gap distance was reduced to 2 nm from 3 nm, and bending depth increases to 9 nm. With these nanoarchitecture control, we improved the plasmonic effect and applied to SERS substrate. In addition, we proved that this nanoarchitecture control affect the performance of SERS substrate (i.e. enhancement factor) and finally applied to sensor application detecting hexavalent chromium. While chapter 3 focuses on narrow gap distance of AuNPs array, chapter 4 target to fabricate the ordered and uniform AuNPs array with narrow gap distance. In this chapter, we modified the surface of AuNPs with polystyrene-thiol that reduce surface charge and methyl-PEG-thiol that reduce steric hindrance. As a result, we obtained uniform and ordered AuNPs array with narrow gap distance. Then, we applied this array to distributed Bragg reflector that is alternatively stacked with AuNPs array and polyurethane acrylate layer, which exhibits high reflectance. Finally, we anticipate that these techniques controlling nanoarchitecture will be widely utilized in research, and leading the advances in engineering fields. 나노기술은 나노물질의 고유한 광학적 특성, 뛰어난 물리적 특성, 큰 비표면적 등의 장점을 바탕으로 현대 과학 및 공학의 상당한 발전을 이끌어 왔다. 이 과정에서 다양한 종류의 나노 구조들이 연구되었다. 특히, 다층 구조의 경우 각 층의 특성을 집적하여 시너지 효과를 이끌어 낼 수 있기 때문에, 산업이나 일상생활같이 다양한 분야에서 개발되고 활용되어 왔다. 그 결과, 다층구조의 나노물질을 활용하는 소자의 성능은 나노 물질의 강점을 바탕으로 향상 되었다. 이러한 추세에 맞추어 다층 구조의 소형화는 여전히 관심을 받고 있다. 현재 활용되는 다층의 나노 구조를 제어하는 기술은 많이 발전되어 수십 nm 수준까지는 제어 가능하기 때문에, 더 많은 특성의 향상을 위해서는 sub-10 nm 수준의 정교한 구조 제어가 필요하다. 하지만 포토리소그래피 같은 전통적인 기술로는 sub-10 nm 구조를 제어하기는 힘들다. 나노 시트나 나노 입자를 활용한 Bottom-up 기반의 조립 공정은 sub-10 nm의 구조를 제작할 수 있으나, 이를 수 nm 수준에서 정교하게 제어하는 것은 상당히 어렵다. 수 nm 수준의 구조 변화가 물질의 특성에 있어 큰 기여를 하는 것을 고려하면, 이러한 수 nm 수준의 나노 구조의 제어가 나노 공학 분야에 있어 필수적이다. 이 점을 해결하기 위해, 이 논문에서, 우리는 나노시트 또는 나노입자의 입체 장애 또는 표면 전하를 조정하는 표면 개질을 활용하여 수 nm 또는 옹스트롬 수준의 나노 구조를 제어할 수 있는 기술을 설명한다. 두번째 장에서, 우리는 입체 장애(steric hindrance)를 유발하는 옥타데실 아민 분자로 산화 그래핀 나노시트의 표면을 개질하여, 산화 그래핀 나노 시트간 거리를 제어하는 방법을 제시한다. 시트 간 거리는 1-2.4 nm 범위에서 옹스트롬 수준으로 제어된다. 게다가, 우리는 시트간 거리를 제어하여 전기화학 표면적의 증대와 그 결과 물질의 전기화학 특성이 향상됨을 보인다. 세번째 장에서, 금 나노 입자에 맥신(MXene) 나노시트가 덮여 있는 이중층 구조에 적용 가능한 기술을 설명한다. 이 기술은 금 나노 입자 주위의 안정재(stabilizer)를 폴리대드맥에서 아민-폴리에틸렌글라이콜-싸이올로 개질하여 금 나노 입자간 거리와 벤딩 구조에서 접힘 정도를 제어할 수 있다. 아민-폴리에틸렌글라이콜-싸이올은 표면 전하를 증가시키고 입체장애를 저해하므로, 금 나노 입자간 거리는 3 nm 에서 2 nm 까지 좁힐 수 있으며, 벤딩 깊이는 9 nm 까지 증대 시킬 수 있다. 이러한 구조 제어를 바탕으로 우리는 플라즈모닉 효과를 향상 시켰으며, 이를 SERS 기판으로 응용하였다. 게다가 우리는 이러한 구조가 SERS 기판의 성능을 향상시킬 수 있음을 보이고, 이를 바탕으로 6가 크롬이온을 검출하는 센서로 응용한다. 세번째 장에서는 금 나노 입자간 거리를 좁히는 것에 집중하였다면, 네번째 장에서는 입자간 거리도 좁으면서 균일하고 정돈된 금 나노 입자 배열을 제작하는 것을 목표로 한다. 이 장에서는 우리는 금 나노 입자 표면을 표면 전하를 감소시킬수 있는 폴리스타이렌-싸이올과 입체 장애를 줄일 수 있는 메틸-폴리에틸렌글라이콜-싸이올을 활용하여 개질하였다. 그 결과, 우리는 입자간 간격이 좁으며 균일하고 정돈된 금 나노 입자 배열을 확보하였고, 이를 금 나노 입자 단일층과 폴리우레탄 아크릴레이트 층이 반복적으로 쌓여있는 구조의 브래그 분산 반사경에 활용하였고, 이러한 반사경은 높은 반사특성을 보였다. 마지막으로 우리는 이러한 나노 구조를 제어하는 기술들이 연구에 널리 활용되어, 나노 공학 분야의 진보를 주도할 것을 기대한다.

Flexible strategy adaptation of multiple supply- demand side management with integrated energy system sizing and distribution network

HAITRA 경희대학교 대학원 2024 국내박사

Flexible strategy adaptation of multiple supply-demand side management with integrated energy system sizing and distribution network. By Nguyen Hoang Hai Tra Doctor of Philosophy in Engineering Graduate School of Kyung Hee University Advised by Prof. ChangKyoo Yoo The boundless energy revolution is gradually maturing with the endless efforts of driving sustainable development goals, insights attaining the strategical solution in energy system management (ESM) for human civilization and sustainability. To satisfy long-term energy sustainability, mitigating the distance between supply and demand in power generation is not terminated at activated propaganda but by trying various collaborative stakeholders to maximize sociotechnical and socioeconomic profits by national and global standards. On the other hand, global energy-related CO2 emission obtains the attention of relevant environmental protection, thus encouraging cleaner technologies as the net-negative emission instruments. Among all participating countries, whether opt-out of the reliance on energy sources with negative environmental impact is an initiative whilst ensuring sufficient supply to consistently develop either a domestic or global beneficial energy-sharing strategy is a challenge. Despite significant achievements, several inquiries could commence investigating to date: ▪ Whether the integrated energy system sizing design underscored the multi-perspective metric of socio-techno-economic-environmental and reliable criteria decision-making is restricted. ▪ Whether tailoring supply-demand response in operating the deep- wide energy distribution network (EDN) satisfies the complexion of social desires with cost-effectiveness. ▪ Whether the ultimate objective of energy sustainability is marked by endless efforts to expand the integration of renewables. ▪ Whether strategic energy policymaking is sufficient toward multiple aspects consideration of spatial and temporal features to adapt to climate change at each local area. Underscoring the points of endeavors and inadequacies in the path of valuable energy effectiveness, this study aims to nominate a roadmap of flexible energy system design, operational management, and effective strategical policymaking, all while striving for high self-sustainable flexibility (SSF) and net-negative emission (N-NE) targets. The comprehensive flow map of economic energy-effectiveness maturity from local to national standard is investigated by solving (1) the optimal design of standalone hybrid renewable energy system (HRES) sizing enhancement while considering multiple socio-techno-econo- environmental and reliable aspects, (2) the multi-response operation of EDN with novel demand-response management and conservation strategy deployment, (3) the SSF conceptualization toward N-NE technology applicability for intending maximal resources recovery, (4) the adaptive risk of climate change insights the deep decentralization network for long-term energy system resilience and (5) the global assessment of energy policy effectiveness in surmounting shortcoming points. The introduction and literature review were introduced in the first chapter of the thesis which recapitulates the intention background of main points in detail with motivative deployment for this research. Following, Chapter 3 leads an integrated design of HRES sizing which targets minimizing the outsources by organizing the energy from the storage system in long-term advance. The various sizing of reasonable stand-alone RES systems was demonstrated by using extended Power Pinch Analysis (EPoPA) with planning integrated storage system to deploy a year manageable operation progress in case of a wastewater treatment plant (WWTP) demand, Vietnam. Alongside Chapter 4, the multi-criteria decision-making based on the techno-socio-econo- environmental and reliability metric is constructed to tailor the decisive HRES sizing with the maximum benefits for finance and society. Initiating integrative schemes of feasible HRES sizing with high techno- socio-econo-environmental and reliability advancement attempts to construct several potential energy operation and management cornerstones in saving and useable energy reasonability, satisfying the unmet demand. This was translated into an integrated qualitative- quantitative assessment, comprising the significant alternatives that accelerated the algorithm's accuracy. Chapter 5 provides an optimal energy system operation of combined energy source generation for multiple demand responses. By integrating optimal scheduling and strategic energy decentralization, our dependable distribution network enhances energy efficiency. Our study introduces a comprehensive bidirectional network with optimal scheduling-based demand-side management (DSM), promoting superior power sharing and overall performance. The DSM ensures equitable power distribution among diverse energy sources, offering a sub-level residential demand response program. In various scenarios, the DSM-based network achieves optimal and balanced power load distribution for residential needs. Moreover, adopting self-generated renewable energy sources (RES) helps address power distribution imbalances. Energy deficits and surpluses are managed through user-installed photovoltaic panels as part of a conservation strategy. CO2 emission was also estimated to assess the environmental impact across different energy source categories. Considering appliance energy consumption satisfaction analysis, EDN efficiently reduces end-user costs, maintains a clean energy profile, and maximizes cost benefits. In chapter 6, a strategic platform for sustainable distribution networks is proposed with minimal energy waste and negative net emissions. Our approach includes multi-stage programming for efficient energy performance, flexible demand response, and equitable sharing of mixed- energy sources to optimize storage and generation. Sustainable transaction governance is prioritized to prevent deficits, supply overload, and excessive CO2 emissions. DSM-based scheduling with bidirectional regulation led to an efficient distribution network with a high economic energy rate and CO2 emission-related energy burden of 0.05 and 0.1, respectively. This approach achieved flexible emission-to-energy generation, recycling, and reliable distribution with an ESM, all rated at 0.05. User satisfaction was also high at 0.7. A promising path is offered to bridge the gap in net emission reduction goals, credit trading, and innovative greenhouse gas mitigation by leveraging CO2 emission

Toward the new Korean musical language : the merging of Korean traditional music and Western music in piano works by contemporary Korean composers

강유선 University of Cincinnati 2002 해외박사

Even though Korea has had contact with Western music for only about one hundred years, Western music has become the mainstream music in South Korea. With the reconsideration of the dominance of Western musical culture, self-criticism of the musical situation began in the 1960s, dealing with two main subjects: understanding the problems of contemporary Korean music in its social context, and the search for ideal music for Korea. Following the theoretical development, various musical experiments have been attempted to address the notion of a new contemporary Korean music which uniquely expresses Korean cultural and national identity and which, at the same time, is universal in appeal to the world. The purpose of this thesis is to provide insights into the musical changes which have taken place in South Korea since the introduction of Western music and to bring to light how Korean composers have attempted to make a new Korean musical language. This thesis is organized into two chapters. Chapter I provides the historical perspectives of Korean music in order to comprehend how the new musical Korean tradition has been formed in contemporary music. It is divided into two sections. The first part traces the introduction of Western music in Korea, and describes phenomena that have appeared in the musical society of Korea after the introduction of Western music, Specifically, dynamic relationships between the two musical cultures, Western and traditional Korean music, are examined in terms of historical, political, and cultural changes in Korea since the late nineteenth century. This discussion also emphasizes how contemporary Korean composers made attempts to develop Korean music with a national identity with the changes of the times. The second part deals with Korean traditional music which is a source of inspiration and materials in contemporary compositions. Chapter II analyzes four selected solo piano works: Korean Dance Suite (1966) by Hoe-Kap Chung, Drei Bagatellen (1973) by Byung-Dong Paik, Korean Rhapsody (1975) by Un-Hoe Park, and Piano Sanjo No. 1 (1987) by Byung-Eun Yoo. The selected works show how these composers attempt to incorporate materials, techniques, and idioms of traditional Korean music into a Western contemporary compositional language. With the summary of the analysis, the conclusion reviews the present musical situation of South Korea and addresses the notion of a new contemporary Korea music with cultural identity and originality.

Sustainable design-operation of a multi-scale decarbonized hydrogen-energy-water nexus system : Explainable-generative AI with coordinated optimization strategies

ABDULRAHMAN BA ALAWI 경희대학교 대학원 2024 국내박사

최근 몇 년간 환경 및 기술적 문제에 대한 사회적 합의를 반영하는 지속 가능한 발전이 전 지구적인 관심사로 떠오르고 있다. 이 사회적 합의의 목적은 저렴한 청정 에너지와 수자원을 제공하는 것이다. 이러한 목적은 많은 연구들이 새로운 물-에너지 시스템의 설계 및 운영의 개선과 더불어 신재생 에너지 (RE, Renewable energy) 의 통합을 연구하도록 유도하였다. 그럼에도 불구하고, 기존 연구들에는 다음과 같이 아직 적절하게 해결되지 못한 주요 한계점들이 있다: • 온실가스 배출을 동반한 높은 에너지 소모량과 복잡한 물-에너지 시스템 관리는 설계 및 운영상의 중요한 문제을 야기한다. 설계 및 운영 조건 개선을 통해 에너지 소비를 유연하게 줄임으로써 지속 가능성을 향상시키는 것이 해결되지 않았다. • 시스템의 복잡성을 고려할 때, 지속 가능한 물-에너지 시스템 관리 분야에서 최적의 자원 분배는 중요한 문제이다. 선행 연구들은 물 혹은 에너지 최적화에만 중점을 두어서, 장기적인 계획과 유연한 규제 전략을 포함한 물-에너지 시스템 연계 방법이 부족하다. • 안전, 경제 및 환경 보호를 종합적으로 고려한 수소 에너지 시스템 설계가 부족하다. 심지어, 기존 수소 저장 기술의 낮은 체적 저장 용량은 반드시 해결되어야 하는 심각한 문제이다. 본 연구는 이러한 한계점들을 수소-물-에너지 넥서스 시스템의 최적 설계와 운영을 통해 해결하였다. 본 연구에서는 지속 가능한 발전에 초점을 맞춘 연계 최적화 (coordinated optimization) 전략 구현하고, 설명가능한 인공지능 (AI, Aritificial intelligence)및 생성형 인공지능과 기술경제성 및 환경성 평가를 합친 방법론을 개발한다. 본 연구의 목표는 최소한의 비용으로 수요를 충족시키고 환경 영향을 최소화하는 유연한 수소 통합 물-에너지 넥서스 시스템의 최적 설계와 스케줄링을 수행하는 것이다. 제1 부는 3장과 4장으로 구성되어 있으며, 상업용 건물의 전력, 난방 및 냉방을 제공하는 다중 캐리어 에너지 시스템 (MCS, Multi-carrier energy system)의 설계와 운영에 대해 논의한다. 3장에서는 MCS의 두 가지 형태를 설명한다: 수소 시설을 사용하는 형태와 기상조건에 의한 신재생 에너지원을 사용하는 형태이다. 두 형태 모두 시스템 비용과 엑서지 감소를 최소화하고, 신뢰성을 극대화하기 위한 2단 최적화 (two-stage optimization) 방법을 사용한다. 연구 결과, 경제적, 엑서지 및 신뢰성 측면에서 수소 시설을 사용하는 형태가 신재생 에너지원에 의존하는 형태보다 우수하였다. 4장에서는 다중 에이전트 강화 학습 (MARL, Multi-agent reinforcement learning) 과 퓨전 오토인코더 (FAE, Fusion autoencoder)를 사용하여 MCS의 지능적 운영 전략을 수립합니다. 다양한 운영 모드를 조사하여 최적의 조건을 식별하고, 최소 비용과 환경 영향을 통해 유연한 수요 충족을 보장합니다. FAE와 저장소를 통합하면 FAE가 없는 시나리오에 비해 97.92%의 높은 수요 충족률과 하루 1991.46 USD의 비용 절감을 달성할 수 있습니다. 또한, 바이오가스 활용은 석탄 및 천연 가스에 비해 각각 97.43% 및 94.37%의 상당한 배출 감소를 보여줍니다. 제 2 부에서는 5장과 6장에서 신재생 에너지 기반 역삼투 (RE-RO, Renewable energy powered Reverse Osmosis)를 이용한 해수담수화 시스템의 설계와 운영을 위한 연계 최적화 (coordinated optimization) 전략을 개발한다. 5장에서는 물 및 에너지 시스템 모두를 고려한 연계 크기 결정 방법을 리더-팔로워 (leader-follower) 최적화 기법을 활용하여 구현한다. 이 방법은 경제적, 환경적 및 신뢰성 측면을 고려하여 RE-RO 시스템의 최적 크기를 결정하기 위한 다중 기준 평가를 통합한다. 연구 결과, RE-RO 시스템의 비용 절감, 낮은 온실가스 배출량 및 신뢰성 향상 등 시스템의 성능이 상당히 향상되었으므로, 개발된 연계 크기 결정 방법이 효과적임을 입증하였다. 6장에서는 RE-RO 시스템의 효율적인 운영과 계획을 수립하기 위한 지능화 전략과 연계 다중 목적 최적화 (coordinated multi-objective optimizaiton) 모델을 통합한 분산형 분배 시스템 (DDS, Decentralized distribution system)을 개발하였다. DDS는 수요 측면의 수도 관리 (DSWM, Demand-side water management)와 분배 네트워크 내 이중 방향 규제 (BDR, Bidirectional regulation)를 통합하여 운영을 최적화한다. 이 방법의 목적은 운영 비용 및 오염물질 배출 비용을 최소화하고, 시스템 회복 탄력성을 극대화하며 수요를 충족하는 것이다. 개발된 통합 DDS는 운영 비용을 17.4% 감소, 이산화탄소 배출량을 46.79% 감소 및 전체 시스템 회복 탄력성의 상당한 향상(70.96%)을 달성하여 우수한 결과를 얻었다. 7장, 8장 및 9장으로 구성된 제 3부에서는 흡착제로 금속-유기 골격체(MOFs, Metal-organic frameworks)를 사용하는 수소 에너지 저장 시스템(HESS, Hydrogen energy storage systems)의 설계를 연구한다. 7장에서는 고압수소가스(GH2), 액체수소(LH2) 및 수소저장합금 (MH2) 기반 수소 저장 시스템을 포함하는 다양한 HESS의 위해성을 평가하기 위한 종합 방법론을 개발한다. 위해성 평가는 HESS의 다양한 설계 인자가 안전에 얼마나 영향을 미치는지에 대한 상세한 조사가 포함한다. 잠재적인 위험을 식별하기 위해 위해성 및 운영성 연구를 통합한 정성적 및 정량적 위해성 평가 모두 사용하였다. 그 후, 목적 함수로 안전 기준을 활용하여, 유전적 알고리즘으로 수소 시스템의 크기를 결정하였다. 그 다음, 다중 기준 의사 결정(MCDM, Multi-criteria decision-making) 방법으로 시스템 구성 요소의 가장 적합한 크기를 선택하였다. GH2가 가장 높은 위해성을 나타내었고, LH2는 높은 잠재 위해성을 나타내었으며, MH2는 GH2 및 LH2에 비해 18.92%의 비용 절감 및 42.86%의 안전성 향상을 나타냈다. 8장과 9장에서는 고용량 수소 흡착제의 발견을 가속하기 위한 설명 가능한 심층 학습 (deep learning) 기반의 스크리닝 및 생성형 인공지능 기반의 설계를 수행했다. 스크리닝을 위해 412,349개의 MOF를 스크리닝하도록 어텐션이 완전 연결된 합성곱 (ADCC, Attention densely connected convolutional) 신경망을 사용했다. 역 설계를 위해 심층 확률적 적대적 생성 신경망 (PGAN, Probabilistic generative adversarial network)을 새로운 MOFs를 생성하는 데 사용했다. MOFs의 물리화학적 특성을 나타내는 24가지 표현자로 구성된 새로운 하이브리드 데이터셋을 다양한 운전 조건과 함께 활용되었다. MOFs의 화학적 표현자를 포함시킴으로써 ADCC 및 PGAN 모델의 성능이 향상되었다. 설명가능한 인공지능 분석 결과, 공극률 및 금속 함유율이 각각 지배적인 물리적 및 화학적 표현자로 나타났다. 마지막으로 ADCC는 수소 저장에서 현재 소재를 능가하는 높은 체적 저장 (UV, Usable volumetric) 및 질량 저장 (UG, Usable gravimetric) 용량을 갖는 실제 MOFs 중 하나인 EFAYIU 를 식별하였다. Sustainable design-operation of a multi-scale decarbonized hydrogen-energy- water nexus system: Explainable generative AI with coordinated optimization strategies By Abdulrahman H. Ba-Alawi Doctor of Philosophy in Integrated Engineering Graduate School of Kyung Hee University Advised by Prof. ChangKyoo Yoo, Ph.D. Sustainable development has gained prominence as a global focus in recent years, reflecting a shared commitment to addressing environmental and technical challenges. Central to this commitment are the goals of ensuring affordable clean energy and water. This emphasis has driven considerable research into improving the design and operation of novel water-energy systems and integrating renewable energy (RE) sources. However, there are significant research gaps that are not adequately covered as listed below: • The high energy consumption associated with emissions and the complex management of water-energy systems pose significant design and operational challenges. There is insufficient focus on enhancing sustainability criteria by flexibly reducing energy consumption through improved design and operational conditions. • Considering the complexity of systems, optimal resource allocation presents a significant challenge in the management of sustainable water-energy systems. The previous focus on either water or energy optimization lacks a coordinated approach with flexible regulation strategies for the long-term planning of the water-energy system. • Hydrogen energy systems lack comprehensive design considerations regarding safety, economics, and environmental protection. Furthermore, the limited volumetric capacity of the existing hydrogen storage technologies is a critical issue that needs to be addressed. In this research, the identified research gaps were addressed through multi- scale analysis for the optimal design and operation of a hydrogen-water-energy nexus system. The methodology establishes frameworks for implementing coordinated optimization strategies, integrating techno-economic and environmental analyses with explainable and generative artificial intelligence (AI) models tailored for sustainable development. This research aims to emphasize the optimal design and scheduling of a flexible hydrogen-integrated water-energy nexus system, with the goal of ensuring demand satisfaction and minimizing environmental impacts at the lowest possible costs. The first part; Chapters 3 and 4, discusses the design and operation of a multicarrier energy system (MCS) that provides power, heating, and cooling demand for commercial buildings. Chapter 3 introduces two configurations of the MCS: one with hydrogen facilities and the other utilizing weather driven RE sources. Both configurations undergo optimal design processes aimed at reducing system costs and exergy destruction, while maximizing the reliability through a two-stage optimization approach. The results underscore that the hydrogen-assisted configuration outperforms the configuration relying on weather-driven RE sources in terms of economics, exergy, and reliability. In Chapter 4, intelligent operational strategies for the MCS are formulated using multi-agent reinforcement learning (MARL) with fusion autoencoder (FAE). Various operation modes are investigated to identify optimal conditions, ensuring flexible demand satisfaction with minimal costs and environmental impacts. Incorporating FAE and storages lead to achieving a high demand satisfaction percentage of 97.92 %, and cost savings of 1991.46 USD/day used compared to scenarios without FAE. While biogas utilization exhibits substantial reductions in emissions compared to coal and natural gas by 97.43 % and 94.37 %, respectively. In the second part, Chapters 5 and 6, coordinated optimization strategies for the design and operation of RE powered reverse osmosis RO (RE-RO) desalination system are proposed. In Chapter 5, a coordinated sizing approach is implemented for both water and energy systems, utilizing a leader-follower optimization framework. This method integrates a multi-criteria assessment to determine the optimal sizes of the RE-RO system, considering economic, environmental, and reliability aspects. The results demonstrate the effectiveness of the developed coordinated sizing approach, leading to substantial improvements in the performance of the RE-RO system, including significant cost reductions, lower emissions, and increased reliability. In Chapter 6, a decentralized distribution system (DDS) is proposed, incorporating a coordinated multi-objective optimization model with intelligent strategies for the efficient operation and planning of the RE-RO system. The DDS optimizes operations by integrating demand-side water management (DSWM) and bidirectional regulation (BDR) within the distribution network. The integration of the proposed DDS results in noteworthy outcomes, including a 17.4% reduction in operational costs, a 46.79% decrease in CO2 emissions, and a significant (70.96%) improvement in overall system resilience. In the third part, Chapters 7, 8, and 9, the design of hydrogen energy storage systems (HESSs) is investigated, considering metal-organic frameworks (MOFs) as adsorbents. In Chapter 7, a comprehensive methodology is introduced to evaluate the risk associated with various HESSs, including gas (GH2), liquid (LH2), and material based (MH2) systems. Both qualitative and quantitative risk assessments, incorporating hazard and operability studies, are employed to identify potential hazards. Subsequently, a genetic algorithm is utilized for system optimization to determine the sizes of the hydrogen system, taking into account safety criteria as an objective function. Then, the multi-criteria decision-making (MCDM) approach is utilized to select the best sizes for the system components. GH2 exhibited the highest cost, LH2 presents the highest inherent risks, while MH2 demonstrates a notable 18.92% cost reduction and a substantial 42.86% improvement in safety compared to GH2 and LH2. In Chapters 8 and 9, an explainable deep learning-based screening and generative AI-based design are proposed to expedite the discovery of high-capacity hydrogen adsorbents. For screening, an attention densely connected convolutional (ADCC) network is used to screen 412,349 MOFs. For inverse design, a deep probabilistic generative adversarial network (PGAN) is used to generate new MOFs. A new hybrid dataset comprising 24 physical and chemical descriptors of MOFs is utilized with various operating conditions. The inclusion of MOFs' chemical descriptors enhances the performance of ADCC and PGAN models. The explainable AI analysis shows that void fraction and metal percentage dominate physical and chemical descriptors, respectively. Consequently, ADCC identifies EFAYIU real MOF with high UV and UG, surpassing current materials in hydrogen storage.

Hendrik Kraemer's missional thought and practice in approaching the non-Christian in Indonesia

Barus, Raskita Torch Trinity Graduate University 2020 국내박사

Hendrik Kraemer’s campaign for mission in Indonesia (1922-1935) was encouraged by John R. Mott’s lecture entitled “A Decisive Hour for the Christian Missions.” Mott delivered the speech after traveling to various Asian countries, including Indonesia, in November 1912 until April 1913. In 1936, after Kraemer ended his mission assignment in Indonesia, the International Missionary Council (represented by John Mott and J. H. Oldham) requested him to write a book of the evangelistic approach to the non-Christian faiths. Therefore, Kraemer wrote the book The Christian Message in A Non-Christian World as an introductory book at the Tambaram Conference (1938). This book was hoped to provide a more biblical insight into Christian mission while at the same time providing an alternative to the book written by William Ernest Hocking entitled Re-Thinking Missions. Hocking emphasized the convergence of all religions into a common way of life. In contrast, in his book, Kraemer emphasized biblical realism as sui generis in understanding reality and the evangelistic approach to all faiths. So, this dissertation investigated and has shown how Kraemer applied the principle of evangelistic approach not only to his theology of mission, but also to his mission approach in Indonesia, especially on the nationalist movement, other faith beliefs, and young Churches. To the inquiry, this dissertation first sought for the background that influenced and shaped Kraemer’s theological thought. In addition, it situated Kraemer’s mission in Indonesia under the Dutch colonial government which interacted strongly with the Dutch mission at the time. It then explored the time Kraemer was in Indonesia, where the Dutch colonial government was implementing an ‘Ethical Policy’ that was expected to win or soften the hearts of the Indonesian people over the oppression they had done before, such as the Cultuursteelsel system (1830-1870). The reaction of the Indonesian people to the policy was the rise of the nationalism movement and religion as well. Furthermore, this dissertation analyzed Kraemer’s understanding of evangelistic approach in his book The Christian Message in A Non-Christian World together with the practical approach he laid down in Indonesia. This dissertation found and have demonstrated that in practical terms Kraemer held to biblical realism, and the same stance led him to emphasize evangelism in his ministry. As a person who strongly emphasized evangelism, Kraemer did not neglect social services and attention to developing political problems. His missionary activities were perceived to have been connected with his commitment to declare the gospel. The same commitment served as the impetus for him to carry out his missionary duties while in Indonesia. Should this study provide an insight for the Church or Christians about the opportunities that remain in evangelism, where Christians have also faded the spirit of evangelism in the midst of the pluralistic wave, we have accomplished our intended purpose. Advisor: Jeongmo Yoo, PhD 460 words

Nutrition Service Practice in Geriatric Long-term Care Hospitals and Nursing Home in Korea

여다영 경희대학교 대학원 2022 국내석사

The study was conducted for the purpose of providing basic data to draw methods to improve the eating habits of the older adults living in long-term care facilities, to cope with a super-aging society by investigating the current state of meals and snacks provided in long-term care hospitals (LH) and long-term care facilities (LF) in Korea. The survey was approved by the Ethics Committees of the Institutional Review Boards of Kyung Hee University (KHGIRB-20-262). It was conducted via offline surveys sent through mail to food service personnel working at LHs and LFs in Korea as well as an online survey on a network site for nutritionists. Excluding surveys with insufficient responses, 118 surveys from LHs, 103 from live-in LFs, and 31 from non-live-in LFs were analyzed. Nutritionists comprised the majority of food service personnel, and their main duties were managing diets, selecting food ingredients, and ordering groceries. Most institutions provided fruits once to thrice a week. The main considerations when providing fruit were in the order of residents’ preference, cost, and ease of consumption. The reasons for not serving fruit included cost as well as differences in the residents’ eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and lack of awareness of the need to provide them. As a result of this study, although most facilities provided snacks, the frequency of the same was low, and the types of provisions were unvaried, consisting of three to four kinds of snacks. To improve the quality of life and the offer benefits of fruits and dairy products to the elderly, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

Effect of Food Preference-Based Weight Loss Program on Body Composition and Quality of Life in Obese Adults

강인경 경희대학교 대학원 2024 국내석사

Recently, interest in personalized nutrition that takes into account an individual's genetic characteristics, epigenetic metabolic characteristics, and various lifestyles is increasing. However, interest in research considering individual food preferences was relatively low. Accordingly, this study was conducted to develop a plan to increase dietary compliance and sustainability by providing a customized diet based on individual preferences, which is different from existing weight control programs that simply use calorie restriction and increased exercise. This study was conducted on adults aged 19 years or older who were obese, with a body mass index of 25 kg/m2 or more or a body fat percentage of 25% or more for men and 30% or more for women, and who responded that they consumed bread or noodles as their staple food at least once a day. A total of 50 subjects were randomly assigned to Bread and Noodles Group (n=25) and Rice Group (n=25), and a diet with the same calorie intake was provided once a day, 5 times a week, for 6 weeks. While both groups received the same customized nutritional education using food diaries, Bread and Noodles Group received a noodle or bread diet reflecting individual preferences, and Rice Group received a rice diet. Changes in weight, body composition, blood levels, and meal intake were measured before and after each intervention. The results of this study showed a significant decrease in BMI (p=0.018; p=0.001), weight (p=0.018; p=0.002), and an increase in Glycoalbumin levels (p=0.002; p=0.001) compared to before the intervention in both groups. Body fat percentage (p=0.005), body fat mass (p=0.000), waist circumference (p=0.017), hip circumference (p=0.002), creatinine (p=0.049), and eGFR (p=0.044) were significant only in Rice Group. decreased significantly. AST levels were significantly decreased only in Bread and Noodles Group (p=0.015). Korean version of Obesity-related QOL scale (KOQOL) results for Bread and Noodles Group: Total score (p=0.000), Social health (p=0.034), Lifestyle (p=0.004), Sexual activity (p= 0.020), and the total score showed a significant difference between groups (p=0.000). Among the total scores for each area of the Mindful Eating Questionnaire (MEQ), which indicates the tendency to overeat and binge due to emotions, Disinhibition (p=0.003), Emotional Response (p=0.048), and External Cues (p=0.002) were significantly different in Bread and Noodles Group. Rice Group showed a significant difference only in External Cues (p=0.009). Additionally, there were no significant differences between groups in any area. As a result, customized diets that reflect individual preferences did not change weight loss or blood levels in obese people, but suggested the possibility of improving quality of life, tendency to binge eat due to emotions, and eating habits. 최근 개인의 유전적 특성, 후성유전적 대사 특성, 다양한 생활 방식 등을 고려한 개인 맞춤 정밀 영양에 대한 관심이 높아지고 있다. 그러나 개인의 식품 기호도를 고려한 연구에 대한 관심은 상대적으로 낮았다. 이에 본 연구에서는 개인의 기호도를 기반으로 맞춤형 식단 제공을 통해 단순히 열량 제한, 운동량 증가만을 이용한 기존의 체중 조절 프로그램과는 차별화된 식이 순응도, 지속성을 높일 수 있는 방안을 마련하기 위해 수행되었다. 본 연구는 만 19세 이상 성인 중 체질량지수 25kg/m2 이상이거나 체지방률 남자 25% 이상/여자 30% 이상인 비만한 자이며, 하루 1회 이상을 빵 또는 면을 주식으로 섭취한다고 응답한 대상으로 수행되었다. 총 50명의 대상자를 A군(n=25) 과 B군(n=25)으로 무작위 배정을 하였으며 섭취 열량이 동일한 식단을 하루 한 끼, 주 5회, 6주 동안 배송으로 제공하였다. 두 군 모두 식사일기를 이용한 맞춤형 영양교육을 동일하게 진행하는 반면에 A군은 개인의 기호를 반영하여 면 또는 빵 식단, B군은 일괄적으로 밥 식단을 배송하였다. 각 중재 전·후에 체중, 체성분, 혈액 수치, 식사량 변화 등을 측정하였다. 본 연구의 결과는 두 군 모두에서 중재 전과 비교하여 BMI (p=0.018; p=0.001), 체중 (p=0.018; p=0.002)수치가 유의성 있게 감소하였고, Glycoalbumin (p=0.002; p=0.001) 수치가 유의성 있게 증가하였다. 체지방률(p=0.005), 체지방량(p=0.000), 허리둘레(p=0.017), 엉덩이둘레(p=0.002), Creatinine (p=0.049), eGFR (p=0.044) 수치는 B군에서만 유의성 있게 감소하였다. AST 수치는 A군에서만 유의성 있게 감소하였다(p=0.015). 한국형 비만과 삶의 질 설문 Korean version of Obesity-related QOL scale (KOQOL) 결과 A군의 Total score (p=0.000), Social health (p=0.034), Lifestyle (p=0.004), Sexual activity (p=0.020) 유의성 있게 감소하였으며, Total score는 유의성 있게 군간 차이를 보였다(p=0.000). 감정에 의해 과식 및 폭식 경향을 나타내는 Mindful Eating Questionnaire (MEQ) 결과 영역별 Total Score 중 Disinhibition (p=0.003), Emotional Response (p=0.048), External Cues (p=0.002)은 A군에서 유의적 차이를 보였으며, B군은 External Cues(p=0.009)에서만 유의적 차이를 보였다. 또한, 모든 영역의 군간 유의적 차이는 없었다. 이러한 결과로 개인의 기호가 반영된 맞춤형 식단은 비만한 사람에게서 체중 감량과 혈액 수치에선 변화가 없었으나, 삶의 질 및 감정에 의한 과식 및 폭식 경향과 식습관 개선 효과의 가능성을 제시하였다.