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The objective of this study was to compare productivity growth and quality changes in teaching and non-teaching hospitals in Taiwan using a quality-based Malmquist productivity index under a metafrontier framework. Researchers have argued that teaching hospitals are more costly than non-teaching hospitals. Whether Taiwanese teaching hospitals operate with higher productivity than non-teaching hospitals is important to determine given increasing financial pressure on hospitals. The results of this study show that, among the Taiwanese teaching and non-teaching hospitals in the study sample, both types of institutions increased in productivity and improved in quality from 2008 to 2014. However, non-teaching hospitals saw much greater positive developments in productivity and quality than teaching hospitals. Therefore, additional teaching and research duties may influence the performance of teaching hospitals in provision of direct patient care. FullText for HTML: https://doi.org/10.1051/ro/2020047

The board of directors of a nonprofit proprietary hospital is responsible for supervising and managing major operational matters and reviewing operational results. This study investigates how hospital financial performance is influenced by director and supervisor characteristics among the board members of nonprofit proprietary hospitals in Taiwan. Data were obtained from the Division of Medical Services of the Ministry of Health and Welfare. A generalized linear model was used to evaluate 32 non-profit proprietary hospitals for the years 2006 to 2017, totaling 363 observations. The empirical results revealed a significant positive correlation between the proportion of directors with management qualifications and hospital financial performance. Moreover, the results represented that a higher proportion of board members with a medical background did not correspond to higher hospital financial performance. Although doctors accounted for the highest proportion of board members, indicating their key role in hospital management, the need for board members with management expertise cannot be ignored. Therefore, a balance between directors with management experience and medical knowledge on the board of directors is beneficial for hospital financial performance.

This study evaluated the fatigue strengthening of the foremost transverse hatch coaming stays of 6 sister container vessels of 2650 TEU capacity that suffered fatigue cracking after 1.0 year operation on a North Pacific route. For that, a simplified method was proposed to validate the fatigue strengthening by providing a target hot spot stress reduction factor as a function of the ship lifetime at the crack occurrence. Afterwards, further seakeeping and structural analyses enabled conducting the spectral fatigue analyses of the considered stays’ original and strengthened designs and, by then, to validate the fatigue strengthening of the stays and the simplified approach. The fatigue driving loads, as well as the effect of the long-term operational profiles uncertainties on the fatigue were also discussed on the basis of the spectral fatigue analyses. Finally, crack growth analyses confirmed the criticality of the examined stays with regards to rapid fatigue cracking when the fatigue damage is not properly considered at the design stage.

The main contribution of network DEA deals with the dual role of deposits in the bank production process. Deposits are first viewed as an intermediate output, produced by, e.g., fractions of labor and capital. This intermediate output is next used as an input in the second process, together with the remaining labor and capital, to produce output combinations. A problem occurs in that network DEA suffers from the difficulty of determining the fractions of labor and capital used in the first process. This research thus develops an economic model to characterize the underlying multi-stage technologies and proposes a copula-based econometric model to identify parameters of the structural equations, including the fractional parameters, by the maximum likelihood. Our model also estimates technical efficiencies of the stochastic production and cost frontiers. We collect data from U.S. banks in 2009 to illustrate the feasibility and usefulness of our modeling, and the results are promising.

This paper proposes a stochastic network model under the framework of the stochastic frontier approach, which allows firms to produce outputs through multistage processes so that we can characterize the underlying technologies and assess technical efficiency in each subsector of a firm. Our model explicitly considers the links among subsectors and overcomes the failure of network DEA that fails to estimate the fractions of shared inputs employed by subsectors, when only aggregate data are available. We compile data from the Chinese banking industry over the period 2002–2015 to exemplify our approach with the help of copula methods. Under the assumption of two production stages - i.e., deposit-gathering and loan-expansion stages - we find that banks allocate roughly 59% and 61% of labor and capital, respectively, to collect deposits in the first stage and that the average technical efficiency scores in both production stages are respectively 68% and 84%. Our study supports the previous findings that joint-stock banks are the most technically efficient, while larger commercial banks, including the big four state-owned banks, are the least technically efficient.

To explore the relationship between baseline information, personal factors, working characteristics and job performance among nurses in emergency department in northern Taiwan. Two-hundred twenty-two nursing staff were interviewed repeated with structured questionnaires for data collection in 3 time points (From August to September, 2008, from February to March, 2009, and from November to December, 2009). The generalized estimating equation (GEE) is used to test the relationship between the domains of independent variables (baseline information, personal factors, working characteristics) and dependent variables (task performance, contextual performance). The mean age of participants is 30.1 ± 5.1 years. 50.0% are junior college or bachelor degrees. From the GEE model, biological protection (β = 0.17, P value = .002) and safety climate (β = 0.24, P value

This paper deals with the heterogeneity problem related to the determination of meta-technology when measuring performance in a dynamic setting. The authors propose a new way of constructing the non-convex meta-framework of the dynamic network data envelopment analysis. This new approach differs from the minimum extrapolation principle on the aggregation of individual group technologies. The proposed model preserves the role of each group's technology in the determination of the proposed non-convex meta-technology. The proposed model also considers the linking activities between the processes and the carry-over activities between two consecutive terms, illustrated by means of a real-world example from banking that simultaneously evaluates: deposit, lending, period, deposit-period and lending-period efficiencies for 22 Taiwanese banks from 2008 to 2016. The empirical results indicate that lending efficiency outperforms deposit efficiency during the sample period, and thus the improvement in deposit activity has a positive effect on banks’ overall performance. The results also imply that non-FHC banks outperform FHC banks on average in terms of both the deposit and lending processes, but the effect is not statistically significant.

Summary Androgen deprivation therapy (ADT) has been the standard treatment for advanced prostate cancer for many decades. Although potential adverse effects of ADT have been reported, there are no empirical studies investigating the association between ADT and Alzheimer's disease. Therefore, this retrospective cohort study explored the relationship between the use of ADT and the subsequent risk of Alzheimer's disease in men with prostate cancer using a population-based database. We retrieved data from the “Taiwan Longitudinal Health Insurance Database 2000.” The study included 1335 patients with prostate cancer and 4005 age-matched comparison patients without prostate malignancy. We then individually tracked each patient (n = 5340) for a 5-year period to discriminate those who subsequently received a diagnosis of Alzheimer's disease. The Cox proportional hazard regression showed that the hazard ratio (HR) for Alzheimer's disease during the 5-year follow-up period for prostate cancer patients was 1.71 (95% confidence interval (CI) = 0.90~3.25) over that of comparison patients. We further analyzed the hazard ratio for Alzheimer's disease and Parkinson's disease between prostate cancer patients who did and those who did not receive ADT, but we failed to observe a significant difference in the hazard ratio for both diseases during the 5-year follow-up period (adjusted HR = 1.76, 95% CI = 0.55~5.62, and HR = 1.13, 95% CI = 0.58~2.20, respectively). In conclusion, this study demonstrated that the use of androgen deprivation therapy in patients with prostate cancer was not associated with a higher risk of Alzheimer's and Parkinson's disease during the follow-up period.

Post-combustion carbon capture is one of the feasible methods to reduce emission of carbon dioxide (CO2) from coal-fired power plants. The biggest challenge in this technology is reduction of energy consumption. This work proposes a hollow fiber based rapid temperature swing adsorption (RTSA) method for capturing CO2 from typical coal-fired power plants. The proposed RTSA approach can shorten the operating time and using low-grade energy for regeneration of adsorption elements. In this study, the tank-in-series model is used to simulate the RTSA process including adsorption and desorption periods. A dual-column operating procedure is then used to treat the flue gas continuously from the coal-fired power plants. Main operating variables including inlet gas volume flow rate (0.1–0.2 m3/s), abandon time (0–10 s), desorption temperature (80–120 °C) on key performance factors such as discharge gas purity, capture ratio of CO2, and energy consumption per unit CO2, etc. are investigated for reducing the energy consumption. This study found that the inlet gas volume flow rate will significantly affect the capture ratio, where smaller gas volume flow rate would be beneficial to increase capture ratio. The abandon time obviously affects the purity of the captured CO2, where the longer abandon time leads to higher purity. Desorption temperature affects both the capture ratio and purity of captured CO2. The higher the desorption temperature, the greater the purity and capture ratio. For one typical basic unit with dual-column hollow fiber-based RTSA, the study found that when the inlet gas volume flow rate is 0.12 m3/s, the desorption waiting time is 7 s, and the desorption temperature is 120 °C, both the CO2 purity and capture ratio can exceed 90%. With considering the possibility of using steam in a low-pressure turbine as a source of heat required for Dual column vacuum RTSA (DC-vRTSA), the impact on the efficiency and stream data of typical coal-fired power plants are calculated. DC-vRTSA at 120 °C, 100 °C and 80 °C will reduce the efficiency of coal-fired power plants by 8.2%, 6%, and 3.4%, respectively.

As the competition in the Taiwanese medical industry becomes increasingly fierce, public hospitals are confronted with challenges in orientation and operations. This study measured changes in the operational efficiency of public and their competitors, non-public hospitals, in Taiwan. This study considered differences in technology and scale between public and non-public hospitals and adopted the quality-incorporating metafrontier Malmquist productivity index to analyze inputs, outputs, and quality achievements of hospitals. The data consisted of 40 public hospitals and 79 non-public hospitals in Taiwan during the period 2008-2014. This study measured productivity growth and quality changes. Moreover, it further identified technological gaps and quality gaps in different types of hospitals with respect to the metafrontier. At the same time, comparisons of changes in quality between public and non-public hospitals were also examined. The empirical results showed that public hospitals were better than non-public ones in terms of productivity. Meanwhile, it was also found that most of the decomposition in productivity was higher in public hospitals than in non-public ones, especially in terms of improvements in technology and quality. This paper presented public hospitals outperformed non-public ones during the research period in spite of the fact that private hospitals had become larger and group-oriented. Therefore, public hospitals and regulators made appropriate adjustments and responses in the face of the pressure of competition in the market.

A capacitively coupled VHF H2 plasma (60 MHz) was produced by a narrow gap discharge at high pressures, and spatial distributions of the plasma parameters were examined with the Langmuir probe. A bi-Maxwellian electron distribution was observed near the discharge electrode while a Maxwellian one near the center of the inter-electrode gap. The simulation using the PIC code showed that electrons had the Druyvesteyn-like distribution near the discharge electrode.

Most commonly interacting Chinese herbs were Ephedrae Herba and Angelicae Sinensis Radix/Angelicae Dahuricae Radix.Unique cultural factors that have resulted in widespread acceptance of both western and traditional Chinese medicine.Taiwan stands well positioned to report on the prevalence of interactions between western drugs and traditional Chinese medicine. BackgroundDrug-drug interactions have long been an active research area in clinical medicine. In Taiwan, however, the widespread use of traditional Chinese medicines (TCM) presents additional complexity to the topic. Therefore, it is important to see the interaction between traditional Chinese and western medicine. Objective(1) To create a comprehensive database of multi-herb/western drug interactions indexed according to the ways in which physicians actually practice and (2) to measure this database's impact on the detection of adverse effects between traditional Chinese medicine compounds and western medicines. MethodsFirst, a multi-herb/western medicine drug interactions database was created by separating each TCM compound into its constituent herbs. Each individual herb was then checked against an existing single-herb/western drug interactions database. The data source comes from the National Health Insurance research database, which spans the years 1998-2011. This study estimated the interaction prevalence rate and further separated the rates according to patient characteristics, distribution by county, and hospital accreditation levels. Finally, this new database was integrated into a computer order entry module of the electronic medical records system of a regional teaching hospital. The effects it had were measured for two months. ResultsThe most commonly interacting Chinese herbs were Ephedrae Herba and Angelicae Sinensis Radix/Angelicae Dahuricae Radix. Ephedrae Herba contains active ingredients similar to in ephedrine. 15 kinds of traditional Chinese medicine compounds contain Ephedrae Herba. Angelicae Sinensis Radix and Angelicae Dahuricae Radix contain ingredients similar to coumarin, a blood thinner. 9 kinds of traditional Chinese medicine compounds contained Angelicae Sinensis Radix/Angelicae Dahuricae Radix. In the period from 1998 to 2011, the prevalence of herb-drug interactions related to Ephedrae Herba was 0.18%. The most commonly prescribed traditional Chinese compounds were MA SHING GAN SHYR TANG (23.1%), followed by SHEAU CHING LONG TANG (15.5%) and DINQ CHUAN TANG (13.2%). The prevalence of herb-drug interactions related to Angelicae Sinensis Radix, Angelicae Dahuricae Radix was 4.59%. The most common traditional Chinese compound formula were TSANG EEL SAAN (32%), followed by HUOH SHIANG JENQ CHIH SAAN (31.4%) and SHY WUH TANG (10.7%).Once the multi-herb drug interaction database was deployed in a hospital system, there were 480 prescriptions that indicated a TCM-western drug interaction. Physicians were alerted 24 times during two months. These alerts resulted in a prescription change four times (16.7%). ConclusionDue to the unique cultural factors that have resulted in widespread acceptance of both western and traditional Chinese medicine, Taiwan stands well positioned to report on the prevalence of interactions between western drugs and traditional Chinese medicine and devise ways to reduce their incidence. This study built a multi-herb/western drug interactions database, embedded inside a hospital clinical information system, and then examined the effects that drug interaction alerts had on clinician prescribing behaviour. The results demonstrated that western drug/traditional Chinese medicine interactions are prevalent and that western-trained physicians tend to change their prescribing behaviour more than traditional Chinese medicine physicians in their response to medication interaction alerts.

Supplemental Digital Content is available in the text, The main objective of this study is to investigate the outcome between surgical procedures and the risk of development of hypoparathyroidism followed by surgical procedure in patients with thyroid disorders. We analyzed the data acquired from Taiwan's Bureau of National Health Insurance (BNHI) research database from 1998 to 2011 and found 9316 patients with thyroid surgery. Cox regression model was used to calculate the hazard ratio (HR). A count of 314 cases (3.4%) of hypoparathyroidism was identified. The 9 years cumulated incidence of hypoparathyroidism was the highest in patient undergone bilateral total thyroidectomy (13.5%) and the lowest in the patient with unilateral subtotal thyroidectomy (1.2%). However, in the patients who had undergone unilateral subtotal, the risk was the highest in bilateral total (HR: 11.86), followed by radical thyroidectomy with unilateral neck lymph node dissection (HR: 8.56), unilateral total (HR, 4.39), and one side total and another side subtotal (HR: 2.80). The extent of thyroid resection determined the risk of development of hypoparathyroidism. It is suggested that the association of these factors is investigated in future studies.

This study attempted to investigate the effects of a tonsillectomy on utilization of medical resources for acute respiratory infections by comparing numbers and costs of clinic visits within 1year before and after a tonsillectomy.Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. The study includes 481 patients aged 18-80years who underwent a tonsillectomy and 481 comparison patients. A multivariate regression model employing difference-in-difference was carried out to assess the independent association between a tonsillectomy and the number and costs of clinic visits.We found that for patients who underwent a tonsillectomy, the mean number of clinic visits for acute respiratory care 1year before and after the index date significantly decreased from 7.3 to 4.2 (p0.001). However, for the comparison group, there was no significant difference in the number (p=0.540) or costs (p=0.221) of clinic visits for acute respiratory care 1year before and after the index date. A multivariate regression model revealed that a tonsillectomy was associated with a reduction of 3.38 in the mean number of clinic visits for acute respiratory care (p0.001). In other words, a tonsillectomy reduced by 46.3% (3.38/7.3) the number of clinic visits for acute respiratory care after adjusting for sociodemographic characteristics and medical comorbidities compared to comparison patients.This study demonstrated that a tonsillectomy was of substantial benefit to adult patients in that it provides decreased healthcare utilization for acute respiratory infections.

Here we demonstrate the fabrication of novel, “quasi-bilayer” inverted organic photovoltaic devices using halogen-free solvents. The inferior solubility of pristine fullerene in non-halogenated solvents was used to control the interpenetration of upper polymeric donor layers with bottom fullerene layers. Notably, island-like nano-morphologies were revealed by AFM, SEM, TEM, cross-sectional TEM images and PL quenching measurement. Correlation between device performance, thin-film nano-morphology and ac impedance was observed. High efficiencies of 6.55% and 7.15% were observed for PBDTTT-C-T and PTB7 cells, respectively. These results demonstrate that this novel process not only offers an effective new method to control the morphology of solar active layers but, more importantly, could also be applied to a wide range of current material systems to produce efficient devices that comply with the non-toxic halogen-free requirement.

Objective The objective of this study was to evaluate productivity growth and quality changes among different levels of accredited hospitals. Design This study used an attribute-incorporating Malmquist productivity index (MPI) under the metafrontier framework. This is the first attempt to compare productivity changes among hospitals operating under different production frontiers. Participants The data consisted of 20 academic medical centers (AMCs), 61 metropolitan hospitals (MPs) and 112 local community hospitals (LCs) in Taiwan during the period 2007–2010. Main outcome measures This study measured productivity growth and further identified technological gaps and catch-ups in different groups of hospitals with respect to the metafrontier. At the same time, comparisons of changes in quality among different levels of hospitals were also examined. Results We found that the sample hospitals of AMCs and MPs experienced productivity improvements mainly due to technological progress, but their efficiency and technology gap ratio (TGR) deteriorated. As for LCs, progress in technology along with improvements in their efficiency and TGR led to the highest productivity upgrade among the three groups of hospitals. We also found that the sample hospitals among the three groups showed improvements in quality. Moreover, hospitals in the local community group exhibited greater quality progress than the AMCs and MPs over the sample period. Conclusion This paper presents a number of useful decompositions of the metafrontier MPI, which can provide useful insights into changes that are due to efficiency, quality improvements and/or technological changes in the healthcare sector.

Conventional parametric stochastic cost frontier models are likely to suffer from biased inferences due to misspecification and the ignorance of allocative efficiency (AE). To fill up the gap in the literature, this article proposes a semiparametric stochastic cost frontier with shadow input prices that combines a parametric portion with a nonparametric portion and that allows for the presence of both technical efficiency (TE) and AE. The introduction of AE and the nonparametric function into the cost function complicates substantially the estimation procedure. We develop a new estimation procedure that leads to consistent estimators and valid TE and AE measures, which are proved by conducting Monte Carlo simulations.

This paper extends the established literature on modeling the cost structures of Europe's banking sectors by combining the Fourier flexible cost function with time-varying technical efficiency (TE) under the framework of the meta-frontier, as proposed by Battese et al. (Journal of Productivity Analysis, Vol. 21 (2004), pp. 91–103) and O'Donnell et al. (Empirical Economics, Vol. 34 (2008), pp. 231–255). We find multiple technologies prevail in the nine sample countries, justifying the use of the meta-cost frontier. Measures TE and technology gap ratios are found to be positively correlated with each other, implying that a relatively technically efficient bank is possibly technologically efficient and vice versa.

In this paper, a propeller design method based on the adjoint method is presented. For the optimization problems, the gradient methods are usually suffering from the inefficient computations of the gradients, and the adjoint method can remedy this problem. In this paper, the adjoint equation of the boundary element method is first derived, and it is then applied to the propeller design problems. The Lagrange-multiplier method with the adjoint equations for solving the gradients is used in this method. Two design examples are demonstrated in the paper, and both examples show that the presented method can successfully achieve the design goals.

Objectives This nationwide population-based study aimed at evaluating healthcare resource utilization and direct medical costs among rheumatoid arthritis (RA) patients receiving biologic therapies in Taiwan. Design and setting A retrospective cohort of 2,425 RA patients who had received first-line tumor necrosis factor (TNF)-α antagonist treatment for at least 6 months (the baseline period) between 2007 and 2011 was identified from the National Health Insurance Research Database in Taiwan. Outcome measures Healthcare resource utilization and direct medical costs of those patients were analyzed and compared 1 year before the index date and during the 1-year follow-up. Results Analytical results demonstrated that 87.7% of RA patients received the same TNF-α antagonist during the 1-year follow-up, 2.4% of the patients switched to another TNF-α antagonist after the baseline period, 7.1% of the study cohort received a second-line biologic agent, while the remaining patients discontinued use of any TNF-α antagonist. Compared to 1 year before the index date, there were significant reductions in emergency room visits and hospitalization days for RA patients treated with the same TNF-α antagonist during the 1-year follow-up. However, there was an increase of outpatient visits among those patients. For those RA patients who switched to another TNF-α antagonist or received a second-line biologic agent, they consumed more healthcare resources. Furthermore, the corresponding medication costs went up markedly during the 1-year follow-up, but nearly all total direct medical costs (biologics excluded) were significantly reduced across the study cohort. Lastly, male patients incurred slightly higher medical costs than their counterparts, albeit in a statistically insignificant fashion. Conclusions This investigation revealed that RA patients treated with biologics utilized fewer emergency room visits and shorter hospitalization days, but incurred higher costs. In summary, this study provides meaningful information on healthcare resource utilization and medical costs of RA patients for healthcare providers and policymakers.

The transition economies are known to have quite different market structures from the market economies. State-owned banks accounts for a major part of the financial sector in East European countries before the transition period. Since the input prices of the sector are frequently under the control of those governments, the misallocated resources may incur the loss of economic efficiency. This paper attempts to gauge the technical and allocative efficiency using unbalanced panel data of 340 banks from 14 transition countries under the framework of the Fourier flexible shadow cost function. Accommodating technical and allocative efficiencies simultaneously, as suggested by Atkinson and Cornwell (Int Econ Rev 35:231–243, 1994a) and Kumbhakar and Wang (J Econom 134:317–340, 2006a), avoids potential specification errors and leads to consistent parameter estimates. The average total cost savings resulting from greater technical and allocative efficiency are around 28.31 and 7.13%, respectively. Foreign-owned banks are found to be the most economically efficient. The enforcement of financial liberalization does gradually improve upon the sample banks’ technical efficiency. The allocative inefficiency arises from over capitalization and excess funds. Scale diseconomies appear to prevail in the sample states with a few exceptions.

The structural characterization correlated to the processing control of hierarchical structure of planar heterojunction perovskite layer is still incomplete due to the limitations of conventional microscopy and X-ray diffraction. This present study performed the simultaneously grazing-incidence small-angle scattering and wide-angle scattering (GISAXS/GIWAXS) techniques to quantitatively probe the hierarchical structure of the planar heterojunction perovskite solar cells. The result is complementary to the currently microscopic study. Correlation between the crystallization behavior, crystal orientation, nano- and meso-scale internal structure and surface morphology of perovskite film as functions of various processing control parameters is reported for the first time. The structural transition from the fractal pore network to the surface fractal can be tuned by the chloride percentage. The GISAXS/GIWAXS measurement provides the comprehensive understanding of concurrent evolution of the film morphology and crystallization correlated to the high performance. The result can provide the insight into formation mechanism and rational synthesis design.

This study evaluated the fatigue life of various hot spots located amidship a handy size oil tanker and a capesize bulk carrier. Specifically, the fatigue was evaluated accordingly to the harmonized common structural rules for bulk carriers and oil tankers recently released by the international association of classification societies. This study examined the stillwater and wave loads uncertainties effect on the fatigue life assessment. Hydro-structure coupling analyses were thus carried out enabling direct hydrodynamic load computations and accurate structural response assessment by finite element analyses. The comparison between direct and rules assessment allowed to identify the load uncertainties effect on the fatigue evaluation. As a result, the fatigue life evaluated by both approaches was significantly different, as expected with regard to the stillwater and dominant wave loads deviations. In addition, the study showed that the influence of the subjected loads was underestimated by the rules, leading to overestimated hot spot stress.Copyright © 2015 by ASME

Date Presented 4/1/2017 This study explores smartphone use in undergraduate students’ self-directed learning. The factors were identified, providing an understanding of how undergraduate students could be more motivated and effective in their short-term, self-directed learning under the influence of smartphone use. Primary Author and Speaker: Ya-chun Chang Additional Authors and Speakers: Kuan-Chen Chen, Wen Ting Chen, Ya-syuan Cai Contributing Authors: Chang-Chih Robin Kuo

Background Developing countries are confronting a steady growth in the prevalence of the infectious diseases. Mobile technologies are widely available and can play an important role in health care at the regional, community, and individual levels. Although labs usually able to accomplish the requested blood test and produce the results within two days after receiving the samples, but the time for the results to be delivered back to clinics is quite variable depending on how often the motorbike transport makes trips between the clinic and the lab. Objective In this study, we seek to assess factors facilitating as well as factors hindering the adoption of mobile devices in the Swazi healthcare through evaluating the end-users of the LabPush system. Methods A qualitative study with semi-structured and in-depth one on one interviews were conducted over two month period July–August 2012. Purposive sampling was used; participants were those operating and using the LabPush system at the remote clinics, at the national laboratory and the supervisors of users at Swaziland. Interview questions were focused on perceived of ease of use and usefulness of the system. All interviews were recorded and then transcribed. Results This study had aimed its primary focus on reducing TAT, prompt patient care, reducing bouncing of patients and defaulting of patients which were challenges that the clinicians have always had. Therefore, the results revealed several barriers and facilitators to the adoption of mobile device by healthcare providers in the Swaziland. The themes Shortens TAT, Technical support, Patient-centered care, Mindset, Improved communication, Missing Reports, Workload, Workflow, Security of smart phone, Human error and Ownership are sorted by facilitators to barriers. Conclusion Thus the end-users perspective, prompt patient care, reduced bouncing of patients, technical support, better communication, willing participant and social influence were facilitators of the adoption m-health in the Swazi healthcare.

The International Association of Classification Societies (IACS) Harmonised Common Structural Rules (CSR-H) have been released and will take effect on July 1, 2015. The local loads under extreme motion conditions, defined in the CSR-H, were investigated for an oil tanker by using computational fluid dynamics (CFD) software, STAR-CCM+, and included bow flare slamming pressure and bottom slamming pressure at the bottom of the bow or stern bottom. The extreme motion defined in the CSR-H was investigated using the potential code HydroSTAR. To benchmark the numerical results, resistance and seakeeping model tests were performed on the oil tanker. The two test results were simulated using the two software packages, respectively, and the numerical results were in good agreement with the test results. Finally, this study demonstrated that the slamming pressures defined by the CSR-H are safe and conservative with regard to the structural design.Copyright © 2014 by ASME

Background Psoriasis is associated with significant economic burdens. Data regarding costs for psoriasis patients in Taiwan are not available. Objective To estimate the economic burden of psoriasis in Taiwan. Methods Psoriasis patients and their controls were identified from the 2006 National Health Insurance (NHI) research database, and differences in annual healthcare utilization and costs between psoriasis cases and controls were predicted by two-part models and generalized linear models. Face-to-face interviews were conducted in five hospital settings to collect information on out-of-pocket payments and productivity losses associated with seeking care. All analyses were stratified by the severity level of psoriasis. Results From the payer’s perspective, the NHI cost associated with moderate to severe psoriasis (sPsO) was NT$41,525 and that with mild psoriasis (mPsO) was NT$14,816. Adding the out-of-pocket payments (NT$13,095 for sPsO and NT$7237 for mPsO) and the loss of productivity (NT$6203 for sPsO and NT$2750 for mPsO), the annual total cost for sPsO was NT$60,823 and that for mPsO was NT$24,803. Conclusion Psoriasis is associated with significant economic burdens in Taiwan. Effective treatment of the disease could produce substantial savings in healthcare resources and gains in productivity.

The spatial profiles of a VHF H2 plasma (60 MHz) for different discharge gap distances were examined at pressures of 66.7 and 133.3 Pa by two-dimensional simulations using the plasma hybrid code. The electron density had a peak profile, and the maximum density depended on both the discharge gap distance and the pressure. A high-electron-density plasma with a low-electron temperature of approximately 1 eV was predicted by simulation at discharge gap distances of 15 and 20 mm. The plasma potential profile was composed of a plateau at the center and sharp slopes at the two sides. The axial profiles of the H+, H2 +, and H3 + densities were calculated for the discharge gap distances of 10, 15, and 20 mm. It was found that the dominant ion species was H3 + except near the discharge electrode and the H2 + density near the discharge electrode was not negligible compared with the H3 + density at 66.7 Pa.

A two-dimensional simulation on a VHF H2 plasma (60 MHz) was performed using the plasma hybrid code, and plasma parameters were examined as a function of pressure for different discharge gaps. It was found that as the pressure increased, the H3 + and H+ densities as well as the electron density had a maximum at a certain pressure, and the maximum shifted to high pressures as the discharge gap decreased. On the other hand, the H2 + density decreased with the increase in pressure, independent of the discharge gap. The axial profiles of the H+, H2 +, and H3 + densities showed that dominant ions were H3 + in our pressure range.

Carrier dynamics in methylammonium lead halide (CH3NH3PbI3–xClx) perovskite thin films, of differing crystal morphology, are examined as functions of temperature and excitation wavelength. At room temperature, long-lived (>nanosecond) transient absorption signals indicate negligible carrier trapping. However, in measurements of ultrafast photoluminescence excited at 400 nm, a heretofore unexplained, large amplitude (50%–60%), 45 ps decay process is observed. This feature persists for temperatures down to the orthorhombic phase transition. Varying pump photon energy reveals that the fast, band-edge photoluminescence (PL) decay only appears for excitation ≥2.38 eV (520 nm), with larger amplitudes for higher pump energies. Lower photon-energy excitation yields slow dynamics consistent with negligible carrier trapping. Further, sub-bandgap two-photon pumping yields identical PL dynamics as direct absorption, signifying sensitivity to the total deposited energy and insensitivity to interfacial effects. Together with first principles electronic structure and ab initio molecular dynamics calculations, the results suggest the fast PL decay stems from excitation of high energy phonon modes associated with the organic sub-lattice that temporarily enhance wavefunction overlap within the inorganic component owing to atomic displacement, thereby transiently changing the PL radiative rate during thermalization. Hence, the fast PL decay relates a characteristic organic-to-inorganic sub-lattice equilibration timescale at optoelectronic-relevant excitation energies.