Impulse response function analysis of the impacts of hospital accreditations on hospital efficiency.

Improving hospital efficiency is an emerging area of interest among policy makers in the new global economy's healthcare system. To ensure accurate efficiency analyses, we consider the nonhomogeneous input/output characteristics of various hospital departments, particularly the Department of Medicine, Department of Surgery, and Department of Other Specialist Medicine. These departments employ co-inputs to produce nonhomogeneous outputs. Specifically, we employ data envelopment analysis to evaluate the efficiency of 15 veterans hospitals in Taiwan. Empirical results show that the performance of the Department of Surgery has higher quality than that of the Department of Medicine and Department of Other Specialist Medicine. In addition, we include another data science technique, namely, impulse response function analysis. The findings indicate that "the New Hospital Accreditation" introduced in 2007 and revised in 2011 improved the efficiency of all departments in their respective first year of introductions. By contrast, the efficiencies of the Department of Surgery and Department of Other Specialist Medicine immediately decreased in the second year after the introductions.

An innovative environmental citizen behavior model: Recycling intention as climate change mitigation strategies.

Climate change has been led to the increasing magnitude of frequency and severity of extreme weather, causing serious damage to overall economy of a country and individual economy of enterprises. Only relying on government subsidy to combat the impact of climate change, the work could be in vain. This study tries to use recycling action as mitigation strategies of climate change, and analyze the dominant influencing factors that affect recycling intention. This study stands in the perspective of green education in universities, regards the recycling intentions in response to climate change as pro-environmental behaviors, and revises and verifies the citizen pro-environmental behavior model. The green educations programs can communicate, promote, active and internalize the environmental citizenship through resource recycling intentions. Students learn about the importance of advocacy and activism to environmental citizenship, then generate environmentally sustainable and recycling intentions, and achieve the goal of improving the environment and mitigating to climate change.

Dynamic eco-efficiency evaluation of the semiconductor industry: a sustainable development perspective.

Serious environmental problems have accompanied remarkable global economic growth for decades. To assist managers in the semiconductor industry with economic and environmental management, this study executes DuPont analysis to examine economic impacts from the effective implementation of sustainability initiatives. We propose a two-stage process including economic development efficiency and environmental protection efficiency through the dynamic data envelopment analysis (DDEA) to reflect the characteristics of eco-efficiency. Through DuPont analysis, the main finding shows the potential improvement in firms' return on equity (ROE) by efficiently utilizing assets to generate sales quickly.Relative to economic development efficiency, the firms show lower scores and higher standard deviations in the environmental protection ability, thus denoting a large gap in the level of environmental protection production technology. The findings in this study reveal that the financial foundations and sustainable development of industries should be improved simultaneously even though specific levels of semiconductor industrial eco-efficiency improvement vary among companies in Taiwan.

Signal amplified colorimetric nucleic acid detection based on autocatalytic hairpin assembly.

Herein, a nucleic acid assay based on autocatalytic hairpin assembly (ACHA) was proposed. In this system, two split G-quadruplex sequences were integrated into H1 and H2, respectively. And a DNA strand with the same sequence to target DNA was integrated into the assistant hairpin H3. In the presence of target DNA, the hairpin structure of H1 was opened and catalytic hairpin assembly (CHA) was activated, and then a series of DNA assembly steps based on the toehold-mediated DNA strand displacement were triggered and the product H1-H2 with sticky ends on both sides was formed. On the one side of H1-H2, the split two G-quadruplex sequences were close enough to form the intact G-quadruplex for the signal readout. At the same time, two sticky ends on the other side of H1-H2 hybridized with H3 and a new sticky end with the sequence same to the target DNA was exposed, which can immediately trigger the autocatalytic hairpin assembly reaction, and then the reaction rate of CHA was effectively accelerated and the colorimetric signal was significantly amplified. This ACHA signal amplified strategy has been successfully applied for the rapid and colorimetric nucleic acid detection.

Thrombomodulin is an ezrin-interacting protein that controls epithelial morphology and promotes collective cell migration.

Adhesive interactions between cells are needed to maintain tissue architecture during development, tissue renewal and wound healing. Thrombomodulin (TM) is an integral membrane protein that participates in cell-cell adhesion through its extracellular lectin-like domain. However, the molecular basis of TM-mediated cell-cell adhesion is poorly understood. Here, we demonstrate that TM is linked to the actin cytoskeleton via ezrin. In vitro binding assays showed that the TM cytoplasmic domain bound directly to the N-terminal domain of ezrin. Mutational analysis of the TM cytoplasmic domain identified (522)RKK(524) as important ezrin-binding residues. In epidermal epithelial A431 cells, TM colocalized with ezrin and actin filaments at cell-cell contacts. Knockdown of endogenous TM expression by RNA interference induced morphological changes and accelerated cell migration in A431 cells. Moreover, epidermal growth factor, upstream of ezrin activation, stimulated the interaction between ezrin and TM. In skin wound healing of mice, TM and ezrin were highly expressed in neoepidermis, implying that both proteins are key molecules in reepithelialization that requires collective cell migration of epithelial cells. Finally, exogenous expression of TM in TM-deficient melanoma A2058 cells promoted collective cell migration. In summary, TM, which associates with ezrin and actin filaments, maintains epithelial morphology and promotes collective cell migration.

A preliminary study on the role of inherited prothrombotic risk factors in Taiwanese patients with sudden sensorineural hearing loss.

Sudden sensorineural hearing loss (SSHL) is a disease with unknown etiology. Recently, several studies revealed that some inherited prothrombotic risk factors are associated with SSHL in western populations. The objective of this study was to investigate the roles of the two most common genetic prothrombotic factors, the factor V Leiden G1691A and prothrombin G20210A in Taiwanese patients with SSHL. Twenty-four patients diagnosed with SSHL of more than 30 dB on average pure tone audiometry (PTA) and thirty-six healthy subjects without a history of hearing loss were enrolled in this study. Genomic DNA was isolated from peripheral blood leukocytes and the single nucleotide polymorphisms (SNPs) genotyping of factor V Leiden G1691A and prothrombin G20210A were analyzed using the TaqMan genotyping assays. Neither factor V Leiden G1691A nor prothrombin G20210A was detected in SSHL patients or in the control subjects. Both the patient group and the control group exhibited wild-type V Leiden 1691GG and wild-type prothrombin 20210GG. In conclusion, the factors V Leiden G1691A and prothrombin G20210A do not seem to play any role in Taiwanese patients with SSHL. Further studies with a large series of patients are needed to identify other possible candidate genes in order to elucidate the pathogenesis of SSHL.

Generating hourly local weather data with high spatially resolution and the applications in bioclimatic performance.

As urbanization expands and diversifies, weather data produced by a single weather station in a suburb are no longer adequate to represent and reflect microclimatic changes of a city. This study selected 34 automatic weather stations in Tainan City, Taiwan, to conduct temperature and humidity measurements over a period of one year. Based on those observed weather data and urban environment parameters obtained from a geographic information system, as well as morphing approach, this study constructed a method of generating hourly local weather data for urban areas while accounting for urban heat island (UHI) effect in summer. Meanwhile, we discussed the relativities of the urban form and its structure against the variations of local hourly temperature and relative humidity under six buffer scenarios. Error analysis results revealed that minimal prediction errors can be obtained using the buffer scenario involving a 1000 × 1000 m2 four-layer buffer with inner and outer layers and upwind and downwind areas. Finally, using the hourly weather data produced for Tainan City, we calculated the long-term cumulative UHI intensity (UHII) and urban bioclimatic indexes (i.e., thermal stress, use of natural ventilation, and cooling degree day) and investigated how urban form and structure are related to UHII, thermal stress, use of natural ventilation, and cooling degree day. The results can inform urban policy making.

Analysis of banned veterinary drugs and herbicide residues in shellfish by liquid chromatography-tandem mass spectrometry (LC/MS/MS) and gas chromatography-tandem mass spectrometry (GC/MS/MS).

Seafood safety is a crucial public health concern for consumers. In this study, we applied a validated method to analyze the residue of banned veterinary drugs in shellfish, namely chloramphenicol, malachite green, leucomalachite green, and nitrofuran metabolites; additionally, the QuEChERS method was employed to detect 76 herbicides by LC/MS/MS and GC/MS/MS. In total, 42 shellfish samples, which included hard clams, freshwater clams, and oysters, were collected from aquafarms and production areas in Taiwan during 2012. Our results revealed 3.8ng/g of chloramphenicol in one hard clam, 19.9-32.1ng/g of ametryn in two hard clams, 16.1-60.1ng/g of pendimethalin in four hard clams, and 17.0ng/g of mefenacet in one oyster, indicating that 19.1% of the samples contained residues from banned veterinary drugs and pesticides. These data can be used to monitor the residue of veterinary drugs and pesticides in aquatic organisms and as a reference for food safety.

Novel synthesis of the ABC rings of solanoeclepin A.

A stereocontrolled synthesis of the ABC rings of solanoeclepin A has been achieved. The seven-membered ring B was synthesized by an intramolecular Prins-ene reaction between an aldehyde and an enyne-dicobalthexacarbonyl complex. The acetylene in this synthesis plays multiple roles: to join the A and C rings, to allow stereoselective cyclization via dicobalthexacarbonyl complexation, and to facilitate Nicholas cation stabilization followed by deprotonation to form an endo-cyclic olefin (Nicholas-Prins cyclization).

Viral factors correlate with hepatitis B e antigen seroconverson in patients with chronic hepatitis B.

BACKGROUND/AIMS: Seroconversion (SC) from hepatitis B envelope antigen (HBeAg) to anti-HBe usually indicates lower viral loads, resolved hepatitis activity and improved long-term outcomes. However, the role of viral factors in the development of SC remains largely unknown. We thus comprehensively studied these factors in 25 patients with sustained HBeAg SC and seven control patients with sustained loss of HBeAg. METHODS: We determined viral factors in serum samples obtained 1 year before, 6 months before, 3 months before, at the time of, 6 months after and 1 year after HBeAg SC or HBeAg loss. Precore A1896 and basal core promoter T1762/A1764 mutants were determined by polymerase chain reaction (PCR)-based assays. Serum HBV levels were determined by a real-time PCR assay. RESULTS: We found that decline of serum viral load, frequently accompanied by hepatitis exacerbation, occurred within 1 year before HBeAg SC. The proportions of precore and BCP mutations also increased gradually throughout the process of HBeAg SC. The virologic features were similar between HBeAg SC group and HBeAg loss group. Before HBeAg SC or loss, genotype B patients had higher serum viral loads and lower proportions of BCP mutation compared with genotype C patients. CONCLUSION: Our findings suggested that viral factors correlate with the development of sustained HBeAg SC or loss.