ABSTRACT
Although the electronic health (e-health) cloud computing system is a promising innovation, its adoption in the healthcare industry has been slow. This study investigated the adoption of e-health cloud computing systems in the healthcare industry and considered security functions, management, cloud service delivery, and cloud software for e-health cloud computing systems. Although numerous studies have determined factors affecting e-health cloud computing systems, few comprehensive reviews of factors and their relations have been conducted. Therefore, this study investigated the relations between the factors affecting e-health cloud computing systems by using a multiple criteria decision-making technique, in which decision-making trial and evaluation laboratory (DEMATEL), DANP (DEMATEL-based Analytic Network Process), and modified VIKOR (VlseKriterijumska Optimizacija I Kompromisno Resenje) approaches were combined. The intended level of adoption of an e-health cloud computing system could be determined by using the proposed approach. The results of a case study performed on the Taiwanese healthcare industry indicated that the cloud management function must be primarily enhanced and that cost effectiveness is the most significant factor in the adoption of e-health cloud computing. This result is valuable for allocating resources to decrease performance gaps in the Taiwanese healthcare industry.
ABSTRACT
We showed previously that transcription of the ran gene in Giardia lamblia is regulated by an AT-rich initiator. In the present study, the ran initiator was found to regulate transcription of a neighbouring PHD zinc-finger protein gene. Deletion and scanning mutagenesis of the phd promoter in a firefly luciferase reporter system showed that the promoter activity is determined by multiple single-stranded T-tract DNA elements distributed into a distal domain spanning the ran initiator (-134/-103) and a proximal domain (-88/-48) spanning phd messenger RNA (mRNA) start sites (-74, -55 and -53 relative to the first ATG). The promoter activity is repressed by the single T-tract element on a non-template strand of the ran initiator, and is activated by closely spaced T-tract elements on the opposite strand. The T-tract elements in the phd and ran initiators compete for similar ssDNA binding proteins. Mutation of -47/-42 resulted in dramatic reduction of luciferase activity without changing luciferase mRNA levels, indicating the potential involvement of a regulatory mechanism in PHD protein translation. These findings suggest that G. lamblia uses multiple copies of a T-tract element as both core and distal elements in regulating transcription initiation, and that expression of the phd gene is regulated at multiple levels.