Empirical Study on the Usage of Telemedicine by Rural and Urban Health Care Consumers in Taiwan: Integrating the Perspectives of Technology Acceptance Model and Theory of Planned Behavior.

Introduction: The outbreak of the novel coronavirus disease-19 posed significant challenges globally, impacting various sectors and health care systems profoundly. In response, telemedicine has emerged as a vital solution to address health care demands and resource shortages. However, there is a lack of comprehensive research on telemedicine usage among health care consumers in urban and rural areas of Taiwan. Methods: This study aimed to investigate the usage, attitudes, and intentions of telemedicine utilization among health care consumers in Taiwan, integrating the Technology Acceptance Model and Theory of Planned Behavior. A cross-sectional study was conducted from April 2023 to May 2024, involving 1,053 participants who utilized telemedicine services. Structured questionnaires were used for data collection, and statistical analyses were performed using SPSS 21.0 software. Results: The results revealed significant disparities in telemedicine utilization between urban and rural areas, with urban residents exhibiting higher levels of perceived ease of use, perceived usefulness, attitude toward use, trust, and intention to use telemedicine. Regression analysis indicated a significant association between urban residence and male gender with telemedicine utilization, contrary to previous research findings. These disparities may stem from differences in health care accessibility and cultural norms prevalent in urban and rural areas. Conclusions: Further investigation into gender differences and interventions to promote telemedicine usage among females, particularly in urban areas, are recommended. This study provides valuable insights for future research and health care policy formulation.

Exploring Telemedicine Usage Intention Using Technology Acceptance Model and Social Capital Theory.

Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Data were collected from 325 healthcare professionals across diverse medical fields. The results indicate that perceived usefulness, ease of use, social influence, and convenience significantly influence intention to use telemedicine. Moreover, age moderates the relationship between perceived usefulness and usage intention. These findings underscore the importance of addressing both technological and social factors in promoting the adoption of telemedicine among healthcare professionals. Policy implications and recommendations for enhancing telemedicine implementation are discussed based on the study findings. Specifically, our findings highlight that perceived usefulness, ease of use, social influence, and convenience significantly impact the intention to use telemedicine technology. Age significantly moderates the relationship between perceived usefulness and usage intention. These results not only theoretically support the UTAUT model but also provide practical strategies to advance the application of telemedicine technology.

A Cross-Sectional Study on the Assessment of Service Quality and User Satisfaction of a Community Support Program in a Region of Taiwan.

This study aims to assess the service quality and user satisfaction of a community support program (CSP) in a specific administrative region of Taiwan. Employing a cross-sectional design, data were collected from 450 CSP users in the region via a questionnaire. Statistical analyses, including descriptive analysis, ANOVA, and Scheffe's Test, were conducted using SPSS 22.0. The findings reveal that users aged 70-79 years with primary education, as well as those with demand or unknown demand for long-term care, reported the highest level of satisfaction with CSP services (mean = 4.5, SD = 0.7, p < 0.05). The study underscores the influence of user characteristics and their understanding of the services on satisfaction levels. These insights provide clear direction for policymakers in shaping the future of CSPs, emphasizing the importance of addressing user needs and enhancing awareness and the utilization of available services.

Nucleus Accumbens Corticotropin-Releasing Hormone Neurons Projecting to the Bed Nucleus of the Stria Terminalis Promote Wakefulness and Positive Affective State.

The nucleus accumbens (NAc) plays an important role in various emotional and motivational behaviors that rely on heightened wakefulness. However, the neural mechanisms underlying the relationship between arousal and emotion regulation in NAc remain unclear. Here, we investigated the roles of a specific subset of inhibitory corticotropin-releasing hormone neurons in the NAc (NAcCRH) in regulating arousal and emotional behaviors in mice. We found an increased activity of NAcCRH neurons during wakefulness and rewarding stimulation. Activation of NAcCRH neurons converts NREM or REM sleep to wakefulness, while inhibition of these neurons attenuates wakefulness. Remarkably, activation of NAcCRH neurons induces a place preference response (PPR) and decreased basal anxiety level, whereas their inactivation induces a place aversion response and anxious state. NAcCRH neurons are identified as the major NAc projection neurons to the bed nucleus of the stria terminalis (BNST). Furthermore, activation of the NAcCRH-BNST pathway similarly induced wakefulness and positive emotional behaviors. Taken together, we identified a basal forebrain CRH pathway that promotes the arousal associated with positive affective states.

Empirical Study on Hospitalist System: A Value Creation Perspective.

This study investigates the impact of hospitalist system awareness, motivation, and behavior on value creation within the healthcare context of Taiwan. As population aging and the prevalence of chronic diseases continue to rise, accompanied by increased medical resource consumption, the Taiwan Ministry of Health and Welfare introduced the hospitalist system. Despite its implementation, the number of participating hospitals remains low. Using a questionnaire survey conducted from October 2021 to March 2022, data were collected from medical teams involved in the hospitalist system. A total of 324 valid questionnaires were analyzed. The results reveal that hospitalist awareness positively influences participation motivation (ß = 0.846, p < 0.001), which subsequently impacts participation behavior positively (ß = 0.888, p < 0.001). Moreover, participation behavior significantly contributes to value creation (ß = 0.869, p < 0.001), along with the direct effect of awareness (ß = 0.782, p < 0.001) on value creation. In conclusion, the successful promotion and implementation of the hospitalist system rely heavily on the support and active participation of medical staff. Effective interactions and comprehensive information dissemination are essential for maximizing healthcare value creation.

Assessing the impact of COVID-19 on outpatient and inpatient revenues: A comparative analysis of large and small hospitals in Taiwan.

BACKGROUND: The COVID-19 pandemic has had profound effects on healthcare systems worldwide, not only by straining medical resources but also by significantly impacting hospital revenues. These economic repercussions have varied across different hospital departments and facility sizes. This study posits that outpatient (OPD) revenues experienced greater reductions than inpatient (IPD) revenues and that the financial impact was more profound in larger hospitals than in smaller hospitals. METHODS: We collected data on patient case numbers and associated revenues for 468 hospitals from the Taiwan government-run National Health Insurance Administration website. We then employed Microsoft Excel to construct scatter plots using the trigonometric function (=DEGREES (Atan (growth rate))) for each hospital. Our analysis scrutinized 4 areas: the case numbers and the revenues (represented by medical fees) submitted to the Taiwan government-run National Health Insurance Administration in both March and April of 2019 and 2020 for OPD and IPD departments. The validity of our hypotheses was established through correlation coefficients (CCs) and chi-square tests. Moreover, to visualize and substantiate the hypothesis under study, we utilized the Kano diagram. A higher CC indicates consistent counts and revenues between 2019 and 2020. RESULTS: Our findings indicated a higher impact on OPDs, with CCs of 0.79 and 0.83, than on IPDs, which had CCs of 0.40 and 0.18. Across all hospital types, there was a consistent impact on OPDs (P = .14 and 0.46). However, a significant variance was observed in the impact on IPDs (P < .001), demonstrating that larger hospitals faced greater revenue losses than smaller facilities, especially in their inpatient departments. CONCLUSION: The two hypotheses confirmed that the COVID-19 pandemic impacted outpatient departments more than inpatient departments. Larger hospitals in Taiwan faced greater financial challenges, especially in inpatient sectors, underscoring the pandemic's varied economic effects. The COVID-19 pandemic disproportionately affected outpatient departments and larger hospitals in Taiwan. Policymakers must prioritize support for these areas to ensure healthcare resilience in future epidemics. The research approach used in this study can be utilized as a model for similar research in other countries affected by COVID-19.

Empirical study on the factors influencing the successful aging of the middle-aged and older adult community volunteers.

Background: The pursuit of successful aging is currently the most important research and policy issue in an aging society. Participating in voluntary services can help middle-aged and older adults recognize the positive value and benefits of social participation, feel a sense of happiness and accomplishment, and improve their overall life satisfaction, which can also contribute to successful aging. This study wants to understand whether the participation motivation and expectation confirmation of middle-aged and older adult volunteering will affect their continuous participation behavior and successful aging because of the satisfaction of actual participation? Objective: This study explores the factors related to middle-aged and older adult volunteering participation and their impact on successful aging. Methods: Middle-aged and older adult volunteering from the East Taiwan Community Development Association and community care centers were taken as the research objects. Convenience sampling was used to select volunteers who were over 45 years old (inclusive) and have participated in voluntary services over five (inclusive) times in the last 6 months. Respondents completed the questionnaire through self-completion or face-to-face interviews with the interviewer. The measurement tools include engagement motivation, expectation validation, satisfaction, ongoing engagement, and successful aging. Results: A total of 536 questionnaires were distributed of which 498 were valid and 38 invalid. The questionnaire recovery rate was 92.91%. Statistical findings include: (1) Those who perceived that their health was good had a better successful aging status than those who perceived that their health was normal. (2) The volunteering participation motivation and expectation confirmation of middle-aged and older adults significantly affected their volunteer participation satisfaction. (3) Participation motivation and expectation confirmation predicted 50.8% of satisfaction. (4) Satisfaction predicted 47.1% of continuous participation. (5) Continuous participation and satisfaction had a predictive power of 65.1% for successful aging. Conclusion: This study confirms that the motivation and expectation of middle-aged and older adult to participate in volunteering will affect their continuous participation behavior and successful aging status through satisfaction. The research results can be used as a reference for the practical work plan of volunteering.

Effect of China's long-term care insurance on health outcomes of older disabled people: role of institutional care.

Since the public long-term care insurance (LTCI) system was piloted in Chengdu, China, in October 2017, there has been considerable growth of LTC institutions in China. This study aimed to evaluate the health value effect of LTCI in older patients with severe disabilities in an LTC institution. This prospective study was based on data from 985 severe disability patients with or without LTCI from October 2017 to May 2021 in the Eighth People's Hospital, Chengdu, China. The Cox proportional hazard model estimated LTCI's health value, including survival probability and risk of pneumonia/pressure ulcers. Subgroup analysis was performed for sex, age, Charlson Comorbidity Index (CCI), and the number of drugs. In the analysis, 519 and 466 patients in LTCI and non-LTCI groups were included, respectively. In adjusted Cox analyses, the LTCI group had a significantly elevated survival rate compared with the non-LTCI groups at 12 months (P < .001, hazard ratio (HR) = 1.758, 95% confidence interval (CI) 1.300-2.376). At 40 months, the adjusted survival rate was 62.6% in the LTCI group, which was significantly higher (53.7%; P = .003, HR = 1.438, 95% CI 1.131-1.831). The subgroups of patients aged 60 to 79 years (interaction P = .007) and with CCI ≥ 3 (interaction P = .026) were more significantly associated with survival improvement than those aged >80 years and with CCI< 3. The LTCI group was also at lower risk for hospital-acquired pneumonia (P = .016, HR 0.622, 95% CI 0.422-0.917) and pressure ulcers (P = .008, HR 0.695, 95% CI 0.376-0.862). The improved survival of LTCI remained stable in sensitivity analyses. For older patients with severe disabilities, in a LTC institution, LTCI significantly improved their health profile and longevity after a year, suggesting the large role and development potentiality of institution care in the LTCI system of China.

The LACE index and risk factors of 14-day versus 30-day readmissions in children.

Risk factors for readmissions in children differ from those in adults, yet little is known about whether the LACE index (Length of stay, Acute admission, Charlson comorbidity index, Emergency department visits in the previous 6 months) developed for adults retains its validity when applied to the prediction of readmissions in children or within shorter intervals of time after discharge. In this retrospective cohort analysis of 4256 patients aged ≤18 years hospitalized at one academic medical center in Taiwan in 2019, we first evaluated the performance of a LACE index model and the three other multivariate logistic regression models in their predictions of hospital readmissions in children using the same time interval of 30 days. We then used multinomial logistic regression to analyze the characteristics and risk factors for readmissions that occur in the first 14 days with those that occur between 15 and 30 days after discharge. The optimal cut-off of the LACE index score for children in the current study was 7, which is less than the optimal score of 10 in the original derivation for adults. The predictive model with the least discriminatory power was based on the LACE score alone, whereas our model that included only two variables (length of stay and the number of admissions in the past 1 year) was found to outperform the LACE index. Multinomial logistic regression results revealed that children who had supplemental private health insurance had lower readmission rates than those insured by the National Health Insurance program only, suggesting a disparity by insurance status. Some risk factors of readmission within 14 days such as acute admissions and supplemental private health insurance were not found to be relevant for longer-term predictions, while age, which was a valid predictor of readmission within 15-30 days, did not affect the prediction of shorter-term readmissions. Prior health care utilization and a higher illness burden were found to be greater contributors to readmissions beyond 14 days. Our simpler model outperformed the more complex LACE tool in identifying children at risk of readmission. Shorter-term readmissions can be attributed to different causes than 30-day readmissions, suggesting a need for different screening tools, interventions, and care support. There remains some socioeconomic disparity associated with readmission rates in the current health care system.

Ultrasensitive quantification of pathogens in milliliters of beverage by filtration-based digital LAMP.

The quantitative detection of pathogens in milliliters of beverage sample requires complex preprocessing. To achieve rapid and ultrasensitive quantification of pathogens in large volume food sample, we developed a filtration-based interfacial digital LAMP (idLAMP) system, which consists of a nanoporous membrane for filtration and nanoporous hydrogel for digital amplification. Digital counting of single bacteria at the membrane surface under nanoconfinement could be achieved. The idLAMP successfully accomplished the quantitative detection of Escherichia coli in 100 mL water samples within 30 min, with wide dynamic range from 0.09 to 900 cells/mL. This technique could also be well applied to the quantification of Escherichia coli and Salmonella typhi in real beverage samples (juice, tea drinks, carbonated drinks and alcoholic drinks) without tedious sample pretreatments. With facile operation, higher specificity and sensitivity and better end-point analysis capabilities, the system has great potential in quantitative counting of single bacteria in large-volume food samples.

Ultrafast and absolute quantification of SARS-CoV-2 on food using hydrogel RT-LAMP without pre-lysis.

With rapid growing of environmental contact infection, more and more attentions are focused on the precise and absolute quantification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus on cold chain foods via point-of-care test (POCT). In this work, we propose a hydrogel-mediated reverse transcription loop-mediated isothermal amplification (RT-LAMP) for ultrafast and absolute quantification of SARS-CoV-2. Cross-linked hydrogel offers opportunities for digital single molecule amplification in nanoconfined spaces, facilitating the virus lysis, RNA reverse transcription and amplification process, which is about 3.4-fold faster than conventional bulk RT-LAMP. Ultrafast quantification of SARS-CoV-2 is accomplished in 15 min without virus pre-lysis and RNA extraction. The sensitivity can accurately quantify SARS-CoV-2 down to 0.5 copy/µL. Furthermore, the integrated system has an excellent specificity, reproducibility and storage stability, which can be also used to test SARS-CoV-2 on various cold chain fruits. The developed ultrafast and simple hydrogel RT-LAMP will be an enormous potential for surveillance of virus or other hazardous microbes in environmental, agricultural and food industry.

SH2B1 Tunes Hippocampal ERK Signaling to Influence Fluid Intelligence in Humans and Mice.

Fluid intelligence is a cognitive domain that encompasses general reasoning, pattern recognition, and problem-solving abilities independent of task-specific experience. Understanding its genetic and neural underpinnings is critical yet challenging for predicting human development, lifelong health, and well-being. One approach to address this challenge is to map the network of correlations between intelligence and other constructs. In the current study, we performed a genome-wide association study using fluid intelligence quotient scores from the UK Biobank to explore the genetic architecture of the associations between obesity risk and fluid intelligence. Our results revealed novel common genetic loci (SH2B1, TUFM, ATP2A1, and FOXO3) underlying the association between fluid intelligence and body metabolism. Surprisingly, we demonstrated that SH2B1 variation influenced fluid intelligence independently of its effects on metabolism but partially mediated its association with bilateral hippocampal volume. Consistently, selective genetic ablation of Sh2b1 in the mouse hippocampus, particularly in inhibitory neurons, but not in excitatory neurons, significantly impaired working memory, short-term novel object recognition memory, and behavioral flexibility, but not spatial learning and memory, mirroring the human intellectual performance. Single-cell genetic profiling of Sh2B1-regulated molecular pathways revealed that Sh2b1 deletion resulted in aberrantly enhanced extracellular signal-regulated kinase (ERK) signaling, whereas pharmacological inhibition of ERK signaling reversed the associated behavioral impairment. Our cross-species study thus provides unprecedented insight into the role of SH2B1 in fluid intelligence and has implications for understanding the genetic and neural underpinnings of lifelong mental health and well-being.

Trend and prediction of citations on the topic of neuromuscular junctions in 100 top-cited articles since 2001 using a temporal bar graph: A bibliometric analysis.

BACKGROUND: A neuromuscular junction (NMJ) (or myoneural junction) is a chemical synapse between a motor neuron (MN) and a muscle fiber. Although numerous articles have been published, no such analyses on trend or prediction of citations in NMJ were characterized using the temporal bar graph (TBG). This study is to identify the most dominant entities in the 100 top-cited articles in NMJ (T100MNJ for short) since 2001; to verify the improved TBG that is viable for trend analysis; and to investigate whether medical subject headings (MeSH terms) can be used to predict article citations. METHODS: We downloaded T100MNJ from the PubMed database by searching the string ("NMJ" [MeSH Major Topic] AND ("2001" [Date - Modification]: "2021" [Date - Modification])) and matching citations to each article. Cluster analysis of citations was performed to select the most cited entities (e.g., authors, research institutes, affiliated countries, journals, and MeSH terms) in T100MNJ using social network analysis. The trend analysis was displayed using TBG with two major features of burst spot and trend development. Next, we examined the MeSH prediction effect on article citations using its correlation coefficients (CC) when the mean citations in MeSH terms were collected in 100 top-cited articles related to NMJ (T100NMJs). RESULTS: The most dominant entities (i.e., country, journal, MesH term, and article in T100NMJ) in citations were the US (with impact factor [IF] = 142.2 = 10237/72), neuron (with IF = 151.3 = 3630/24), metabolism (with IF = 133.02), and article authored by Wagh et al from Germany in 2006 (with 342 citing articles). The improved TBG was demonstrated to highlight the citation evolution using burst spots, trend development, and line-chart plots. MeSH terms were evident in the prediction power on the number of article citations (CC = 0.40, t = 4.34). CONCLUSION: Two major breakthroughs were made by developing the improved TBG applied to bibliographical studies and the prediction of article citations using the impact factor of MeSH terms in T100NMJ. These visualizations of improved TBG and scatter plots in trend, and prediction analyses are recommended for future academic pursuits and applications in other disciplines.

Patient-centred e-health supports value cocreation and quality of medical care in Taiwan.

BACKGROUND: Patient-centred e-health (PCEH) focusses on the interaction between patients and physicians. However, only a limited number of studies have focussed on the design of physician-patient value cocreation mechanisms in the PCEH context. Thus, we extend Grönroos' concept of value cocreation to understand how PCEH might improve the quality of care. OBJECTIVES: This study proposes a theoretical framework to embody PCEH-supported value cocreation and presents some empirical validation. We expect that PCEH-supported value cocreation should comprise capabilities for patient empowerment, intention for information sharing, complementation for checking and verifying information, and interaction for shared understanding. METHODS: This study surveyed a small group of patients that have used PCEH, 'My Health Bank' in Taiwan. The questionnaires were delivered to patients in hospitals (n = 167 questionnaires, 98% response rate). RESULTS: Results indicate that certain PCEH-supported value cocreation mechanisms-capabilities for patient empowerment and interaction for shared understanding-affect the perceived quality of medical care. LIMITATIONS: The survey only considered patient perceptions of value cocreation. CONCLUSION: This study shows the patient perception of value cocreation in patient-centred e-Health. Further research needs to validate the framework for health professionals and in other e-Health record information sharing settings.

Flexible, non-contact and multifunctional humidity sensors based on two-dimensional phytic acid doped co-metal organic frameworks nanosheets.

The development of high-performance humidity sensors is of great significance to explore their practical applications in the fields of environment, energy saving and safety monitoring. Herein, a flexible, non-contact and multifunctional humidity sensor based on two-dimensional Co-metal organic frameworks (Co-MOF) nanosheets is proposed, which is fabricated by simple bottom-up synthesis method. Furthermore, environmentally friendly, renewable and abundant biomass phytic acid (PA) is modified on the surface of Co-MOF nanosheets, which releases free protons being capable of etching the framework of MOF to improve the hydrophilicity and conductivity of MOF. Compared with Co-MOF-based sensor, the Co-MOF@PA-based sensor exhibits significantly enhanced sensitivity and broadened response range within 23-95% relative humidity (RH). The humidity sensor has an excellent humidity sensing response over 2 × 103. The Co-MOF@PA-based sensor shows good flexibility and humidity sensing properties, endowing it with multifunctional applications in real-time facial respiration monitoring, skin humidity perception, cosmetic moisturizing evaluation and fruit freshness testing. Four respiration patterns, including slow breath, deep breath, normal breath and fast breath are wirelessly monitored in real time by Co-MOF@PA-based sensor and recorded by mobile phone software. The research work presents potential applications in human-machine interactions (HMI) devices in future.

An application for classifying perceptions on my health bank in Taiwan using convolutional neural networks and web-based computerized adaptive testing: A development and usability study.

BACKGROUND: The classification of a respondent's opinions online into positive and negative classes using a minimal number of questions is gradually changing and helps turn techniques into practices. A survey incorporating convolutional neural networks (CNNs) into web-based computerized adaptive testing (CAT) was used to collect perceptions on My Health Bank (MHB) from users in Taiwan. This study designed an online module to accurately and efficiently turn a respondent's perceptions into positive and negative classes using CNNs and web-based CAT. METHODS: In all, 640 patients, family members, and caregivers with ages ranging from 20 to 70 years who were registered MHB users were invited to complete a 3-domain, 26-item, 5-category questionnaire asking about their perceptions on MHB (PMHB26) in 2019. The CNN algorithm and k-means clustering were used for dividing respondents into 2 classes of unsatisfied and satisfied classes and building a PMHB26 predictive model to estimate parameters. Exploratory factor analysis, the Rasch model, and descriptive statistics were used to examine the demographic characteristics and PMHB26 factors that were suitable for use in CNNs and Rasch multidimensional CAT (MCAT). An application was then designed to classify MHB perceptions. RESULTS: We found that 3 construct factors were extracted from PMHB26. The reliability of PMHB26 for each subscale beyond 0.94 was evident based on internal consistency and stability in the data. We further found the following: the accuracy of PMHB26 with CNN yields a higher accuracy rate (0.98) with an area under the curve of 0.98 (95% confidence interval, 0.97-0.99) based on the 391 returned questionnaires; and for the efficiency, approximately one-third of the items were not necessary to answer in reducing the respondents' burdens using Rasch MCAT. CONCLUSIONS: The PMHB26 CNN model, combined with the Rasch online MCAT, is recommended for improving the accuracy and efficiency of classifying patients' perceptions of MHB utility. An application developed for helping respondents self-assess the MHB cocreation of value can be applied to other surveys in the future.

Comparison of Back-Propagation Neural Network, LACE Index and HOSPITAL Score in Predicting All-Cause Risk of 30-Day Readmission.

BACKGROUND: The main purpose of this study is to predict the all-cause risk of 30-day readmission by employing the back-propagation neural network (BPNN) in comparison with traditional risk assessment tools of LACE index and HOSPITAL scores. METHODS: This was a retrospective cohort study from January 1st, 2018 to December 31st, 2019. A total of 55,688 hospitalizations from a medical center in Taiwan were examined. The LACE index (length of stay, acute admission, Charlson comorbidity index score, emergency department visits in previous 6 months) and HOSPITAL score (hemoglobin level at discharge, discharge from an Oncology service, sodium level at discharge, procedure during hospital stay, Index admission type, number of hospital admissions during the previous year, length of stay) are calculated. We employed variables from LACE index and HOSPITAL score as the input vector of BPNN for comparison purposes. RESULTS: The BPNN constructed in the current study has a considerably better ability with a C statistics achieved 0.74 (95% CI 0.73 to 0.75), which is statistically significant larger than that of the other two models using DeLong's test. Also, it was possible to achieve higher sensitivity (70.32%) without penalizing the specificity (71.76%) and accuracy (71.68%) at its optimal threshold, which is at the 20% of patients with the highest predicted risk. Moreover, it is much more informative than the other two methods because of a considerably higher LR+ and a lower LR-. CONCLUSION: Our findings suggest that more attention should be paid to methods based on non-linear classification systems, as they lead to substantial differences in risk-scores.

A preliminary study on applying holistic health care model on medical education behavioral intention: a theoretical perspective of planned behavior.

BACKGROUND: This study aimed to apply the theory of planned behavior to identify the medical education behavioral intention of holistic healthcare on teachers and students who influence the medical and healthcare profession, as a revised future direction for hospitals to continue to implement holistic healthcare. METHODS: This cross-sectional study was performed from April to May 2020. A questionnaire survey was conducted with the clinical teachers and students of the medical and healthcare profession in an individual Taiwan hospital as study subjects, based on judgmental sampling, and the study tool was a structured questionnaire. RESULTS: A total of 360 valid samples were collected, 105 clinical teachers (29.2%) and 255 students (70.8%). Demographic variables were significantly different between clinical teachers (mean = 3.91) and students (mean = 3.73) (p = 0.023). Post hoc analysis regarding work experience found that those with work experience < 2 years (mean = 3.94) had higher results than those with 6-10 years (mean = 3.61) (p = 0.019). The results of multiple regression analysis indicate that the factors affecting medical education behavioral intention are subjective norm (t = 3.571, p < 0.001) and perceived behavioral control (t = 11.870, p < 0.001). CONCLUSIONS: With respect to medical education behavioral intention, clinical teachers and students are affected by the subjective norm and perceived behavioral control. It is recommended that, in the curriculum of holistic medical education, designing holistic medical education teaching templates and check forms can encourage clinical teachers to re-examine their beliefs in teaching, learning, and knowledge. The results of this study allow the advocator to consider from a broader view making policies of and promoting the platform of holistic healthcare on medical education. It is recommended that future researchers conduct research, investigation, and analysis on other stakeholders.

Recent Advances in Natural Functional Biopolymers and Their Applications of Electronic Skins and Flexible Strain Sensors.

In order to replace nonrenewable resources and decrease electronic waste disposal, there is a rapidly rising demand for the utilization of reproducible and degradable biopolymers in flexible electronics. Natural biopolymers have many remarkable characteristics, including light weight, excellent mechanical properties, biocompatibility, non-toxicity, low cost, etc. Thanks to these superior merits, natural functional biopolymers can be designed and optimized for the development of high-performance flexible electronic devices. Herein, we provide an insightful overview of the unique structures, properties and applications of biopolymers for electronic skins (e-skins) and flexible strain sensors. The relationships between properties and sensing performances of biopolymers-based sensors are also investigated. The functional design strategies and fabrication technologies for biopolymers-based flexible sensors are proposed. Furthermore, the research progresses of biopolymers-based sensors with various functions are described in detail. Finally, we provide some useful viewpoints and future prospects of developing biopolymers-based flexible sensors.

The use of forest plot to identify article similarity and differences in characteristics between journals using medical subject headings terms: A protocol for bibliometric study.

BACKGROUND: Comparison of similarity and difference in research types among journals are concerned in literature. However, to date, none display the methodology seen in selecting similar journals related to the target journal, as similar articles did to a given article. Authors need 1 effective method not only to find similar journals for their studies but also to know the difference in methods. This study (1) shows the similar journals for the target journal online displayed, and (2) identifies the effect of similarity odds ratio compared to the counterparts using the forest plots in Meta-analysis and the major medical subject headings (MeSH terms). METHODS: We downloaded 1000 recent top 20 most similar articles related to the Respiratory Care journal from the PubMed library, plotted the clusters of related journals using social network analysis (SNA), and compared the MeSH terms in differences in an odds ratio unit using the forest plot relevant to Respiratory Care and the most similar journals. Q statistic and I-square (I2) index were used to evaluate the difference in the proportion of events. RESULTS: This study found that (1) the journals related to Respiratory Care are easily presented on Google Maps; (2) 10 journal clusters were identified using SNA; (3) the top 3 MeSH terms are methods, therapy, and physiopathology, and (4) the odds ratios of MeSH terms between journals associated with the Respiratory Care showing different from Int J Chron Obstruct Pulmori Dis and similar to Curr Opin Endocrinol Diabetes Obes within heterogeneity with I2 = 70.5% (P < 0.001) and 0% (P = 0.803), respectively. CONCLUSIONS: SNA and forest plots provide deep insight into the relationships between journals in MeSH terms. The results of this research can provide readers with a concept diagram that can be used for future submissions to a given journal.