Search results for: Jeffrey Chiu
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 130

Search results for: Jeffrey Chiu

70 The Role of Phycoremediation in the Sustainable Management of Aquatic Pollution

Authors: Raymond Ezenweani, Jeffrey Ogbebor

Abstract:

The menace of aquatic pollution has become increasingly of great concern and the effects of this pollution as a result of anthropogenic activities cannot be over emphasized. Phycoremediation is the application of algal remediation technology in the removal of harmful products from the environment. Harmful products also known as pollutants are usually introduced into the environment through variety of processes such as industrial discharge, agricultural runoff, flooding, and acid rain. This work has to do with the capability of algae in the efficient removal of different pollutants, ranging from hydrocarbons, eutrophication, agricultural chemicals and wastes, heavy metals, foul smell from septic tanks or dumps through different processes such as bioconversion, biosorption, bioabsorption and biodecomposition. Algae are capable of bioconversion of environmentally persistent compounds to degradable compounds and also capable of putting harmful bacteria growth into check in waste water remediation. Numerous algal organisms such as Nannochloropsis spp, Chlorella spp, Tetraselmis spp, Shpaerocystics spp, cyanobacteria and different macroalgae have been tested by different researchers in laboratory scale and shown to have 100% efficiency in environmental remediation. Algae as a result of their photosynthetic capacity are also efficient in air cleansing and management of global warming by sequestering carbon iv oxide in air and converting it into organic carbon, thereby making food available for the other organisms in the higher trophic level of the aquatic food chain. Algae play major role in the sustenance of the aquatic ecosystem by their virtue of being photosynthetic. They are the primary producers and their role in environmental sustainability is remarkable.

Keywords: Algae , Pollutant, ., Phycoremediation, Aquatic, Sustainability

Procedia PDF Downloads 87
69 The Amount of Information Processing and Balance Performance in Children: The Dual-Task Paradigm

Authors: Chin-Chih Chiou, Tai-Yuan Su, Ti-Yu Chen, Wen-Yu Chiu, Chungyu Chen

Abstract:

The purpose of this study was to investigate the effect of reaction time (RT) or balance performance as the number of stimulus-response choices increases, the amount of information processing of 0-bit and 1-bit conditions based on Hick’s law, using the dual-task design. Eighteen children (age: 9.38 ± 0.27 years old) were recruited as the participants for this study, and asked to assess RT and balance performance separately and simultaneously as following five conditions: simple RT (0-bit decision), choice RT (1-bit decision), single balance control, balance control with simple RT, and balance control with choice RT. Biodex 950-300 balance system and You-Shang response timer were used to record and analyze the postural stability and information processing speed (RT) respectively for the participants. Repeated measures one-way ANOVA with HSD post-hoc test and 2 (balance) × 2 (amount of information processing) repeated measures two-way ANOVA were used to test the parameters of balance performance and RT (α = .05). The results showed the overall stability index in the 1-bit decision was lower than in 0-bit decision, and the mean deflection in the 1-bit decision was lower than in single balance performance. Simple RTs were faster than choice RTs both in single task condition and dual task condition. It indicated that the chronometric approach of RT could use to infer the attention requirement of the secondary task. However, this study did not find that the balance performance is interfered for children by the increasing of the amount of information processing.

Keywords: capacity theory, reaction time, Hick’s law, balance

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68 Graphene Based Materials as Novel Membranes for Water Desalination and Boron Separation

Authors: Francesca Risplendi, Li-Chiang Lin, Jeffrey C. Grossman, Giancarlo Cicero

Abstract:

Desalination is one of the most employed approaches to supply water in the context of a rapidly growing global water shortage. However, the most popular water filtration method available is the reverse osmosis (RO) technique, still suffers from important drawbacks, such as a large energy demands and high process costs. In addition some serious limitations have been recently discovered, among them, the boron problem seems to have a critical meaning. Boron has been found to have a dual effect on the living systems on Earth and the difference between boron deficiency and boron toxicity levels is quite small. The aim of this project is to develop a new generation of RO membranes based on porous graphene or reduced graphene oxide (rGO) able to remove salts from seawater and to reduce boron concentrations in the permeate to the level that meets the drinking or process water requirements, by means of a theoretical approach based on density functional theory and classical molecular dynamics. Computer simulations have been employed to investigate the relationship between the atomic structure of nanoporous graphene or rGO monolayer and its membrane properties in RO applications (i.e. water permeability and resilience at RO pressures). In addition, an emphasis has been given to multilayer nanoporous rGO and rGO flakes based membranes. By means of non-equilibrium MD simulations, we investigated the water transport mechanism permeating through such multilayer membrane focusing on the effect of slit widths and sheet geometries. These simulations allowed us to establish the implications of these graphene based materials as promising membrane properties for desalination plants and as boron filtration.

Keywords: boron filtration, desalination, graphene membrane, reduced graphene oxide membrane

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67 Characteristics of Old-Growth and Secondary Forests in Relation to Age and Typhoon Disturbance

Authors: Teng-Chiu Lin, Pei-Jen Lee Shaner, Shin-Yu Lin

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Both forest age and physical damages due to weather events such as tropical cyclones can influence forest characteristics and subsequently its capacity to sequester carbon. Detangling these influences is therefore a pressing issue under climate change. In this study, we compared the compositional and structural characteristics of three forests in Taiwan differing in age and severity of typhoon disturbances. We found that the two forests (one old-growth forest and one secondary forest) experiencing more severe typhoon disturbances had shorter stature, higher wood density, higher tree species diversity, and lower typhoon-induced tree mortality than the other secondary forest experiencing less severe typhoon disturbances. On the other hand, the old-growth forest had a larger amount of woody debris than the two secondary forests, suggesting a dominant role of forest age on woody debris accumulation. Of the three forests, only the two experiencing more severe typhoon disturbances formed new gaps following two 2015 typhoons, and between these two forests, the secondary forest gained more gaps than the old-growth forest. Consider that older forests generally have more gaps due to a higher background tree mortality, our findings suggest that the age effects on gap dynamics may be reversed by typhoon disturbances. This study demonstrated the effects of typhoons on forest characteristics, some of which could negate the age effects and rejuvenate older forests. If cyclone disturbances were to intensity under climate change, the capacity of older forests to sequester carbon may be reduced.

Keywords: typhoon, canpy gap, coarse woody debris, forest stature, forest age

Procedia PDF Downloads 238
66 Body-Worn Camera Use in the Emergency Department: Patient and Provider Satisfaction

Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

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Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

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65 Factors of Major Depressive Disorder (MDD): Prevalence of Social Support on Stress within Parental Depression

Authors: Calvin Chiu, Samar Saade Needham

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The factors associated with the development of major depressive disorder (MDD) have been an ongoing area of concern within the field of psychopathology. Among parents, the rise in stress factors for individuals receiving less social support contributes to an increase in MDD cases. Understanding the causal aspects of MDD through the interworking of stress development within social support disparities provides critical insights into preventive measures for depressive symptoms. The present study seeks to assess the impact of social support on stress formation within MDD. Such that single parents lacking social support prompt an increase in stress formation, which proliferates the progression of MDD. Participants in this study were 450 ethnic minority mothers and fathers experiencing health inequities during pregnancy and early childhood. Perceived stress, social support, and depression are assessed by multi-item questionnaires that produce score ranges for general findings. Results indicated that lower social support scores resulted in higher depression scores, and higher perceived stress scores produced higher depression scores. Furthermore, single parents reported higher depression scores. These findings overlap with studies on paternal depression and suggest that MDD is a product of stress accumulation due to declining social support systems. Future studies may specify effective social support systems for decreasing stress accumulation in MDD formation in preventive strategies.

Keywords: major depressive disorder, stress formation, cognitive-behavioral outcomes, deficit-based behaviors

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64 Impact of Education on Levels of Physical Activity and Depression in Taiwanese Vegetarians and Omnivores

Authors: Ya-Lin Chang, Chia Chen Chang, Yu-Ru Liang, Joyce Chen, You-Kang Chang, Tina Chiu

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Physical activity and mental health status are important for health. The purpose of this study was to examine levels of physical activities and depression in Taiwanese vegetarians (VEG) and omnivores (OMNI). Sixty-three vegetarians (20 males) and 56 omnivores (23 males) with an average age of 51 years were recruited for a food frequency validation study at Taipei Tzu Chi Hospital from July to September in 2016. Participants filled out a validated Chinese version international physical activity questionnaire-short-form (IPAQ), Beck Depression Inventory-II-Chinese version (BDI), food frequency questionnaire (FFQ) and a questionnaire on demographics and medical history upon recruitment. Total BDI scores were calculated for depression and the metabolic equivalent of task (MET) was calculated for physical activity levels. Mann-Whitney U tests and Chi-square test were used to compare demographics, physical activity levels and depression scores. VEG and OMNI did not differ significantly on MET (1441.9 ± 3387.3 vs. 1605.8 ± 2486.1. p=0.2652, respectively). VEG scored slightly lower on BDI compared to OMNI without statistical significance (5.6 ± 5.7 vs. 7.4 ± 6.3. p=0.06). In addition, we found that regardless of diet practice, those who held a college degree and above scored better on MET (1788.1 ± 2532.6 vs. 1215.5 ± 3425.5. p=0.0014) and BDI (5.2 ± 5.1 vs. 7.8 ± 6.7. p=0.03). In this cross-sectional study, Taiwanese vegetarians and omnivores scored comparatively on physical activity levels and depression. However, education is a significant determinant of physical activity and depression.

Keywords: BDI, diet, education, physical activity

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63 Development of Nondestructive Imaging Analysis Method Using Muonic X-Ray with a Double-Sided Silicon Strip Detector

Authors: I-Huan Chiu, Kazuhiko Ninomiya, Shin’ichiro Takeda, Meito Kajino, Miho Katsuragawa, Shunsaku Nagasawa, Atsushi Shinohara, Tadayuki Takahashi, Ryota Tomaru, Shin Watanabe, Goro Yabu

Abstract:

In recent years, a nondestructive elemental analysis method based on muonic X-ray measurements has been developed and applied for various samples. Muonic X-rays are emitted after the formation of a muonic atom, which occurs when a negatively charged muon is captured in a muon atomic orbit around the nucleus. Because muonic X-rays have higher energy than electronic X-rays due to the muon mass, they can be measured without being absorbed by a material. Thus, estimating the two-dimensional (2D) elemental distribution of a sample became possible using an X-ray imaging detector. In this work, we report a non-destructive imaging experiment using muonic X-rays at Japan Proton Accelerator Research Complex. The irradiated target consisted of polypropylene material, and a double-sided silicon strip detector, which was developed as an imaging detector for astronomical observation, was employed. A peak corresponding to muonic X-rays from the carbon atoms in the target was clearly observed in the energy spectrum at an energy of 14 keV, and 2D visualizations were successfully reconstructed to reveal the projection image from the target. This result demonstrates the potential of the non-destructive elemental imaging method that is based on muonic X-ray measurement. To obtain a higher position resolution for imaging a smaller target, a new detector system will be developed to improve the statistical analysis in further research.

Keywords: DSSD, muon, muonic X-ray, imaging, non-destructive analysis

Procedia PDF Downloads 176
62 Solvent-Aided Dispersion of Tannic Acid to Enhance Flame Retardancy of Epoxy

Authors: Matthew Korey, Jeffrey Youngblood, John Howarter

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Background and Significance: Tannic acid (TA) is a bio-based high molecular weight organic, aromatic molecule that has been found to increase thermal stability and flame retardancy of many polymer matrices when used as an additive. Although it is biologically sourced, TA is a pollutant in industrial wastewater streams, and there is a desire to find applications in which to downcycle this molecule after extraction from these streams. Additionally, epoxy thermosets have revolutionized many industries, but are too flammable to be used in many applications without additives which augment their flame retardancy (FR). Many flame retardants used in epoxy thermosets are synthesized from petroleum-based monomers leading to significant environmental impacts on the industrial scale. Many of these compounds also have significant impacts on human health. Various bio-based modifiers have been developed to improve the FR of the epoxy resin; however, increasing FR of the system without tradeoffs with other properties has proven challenging, especially for TA. Methodologies: In this work, TA was incorporated into the thermoset by use of solvent-exchange using methyl ethyl ketone, a co-solvent for TA, and epoxy resin. Samples were then characterized optically (UV-vis spectroscopy and optical microscopy), thermally (thermogravimetric analysis and differential scanning calorimetry), and for their flame retardancy (mass loss calorimetry). Major Findings: Compared to control samples, all samples were found to have increased thermal stability. Further, the addition of tannic acid to the polymer matrix by the use of solvent greatly increased the compatibility of the additive in epoxy thermosets. By using solvent-exchange, the highest loading level of TA found in literature was achieved in this work (40 wt%). Conclusions: The use of solvent-exchange shows promises for circumventing the limitations of TA in epoxy.

Keywords: sustainable, flame retardant, epoxy, tannic acid

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61 Gellan Gum/Gamma-Polyglutamic Acid and Glycerol Composited Membrane for Guiding Bone Regeneration

Authors: Chi-Chang Lin, Jiun-Yan Chiu

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Periodontal disease, oral cancer relating trauma is the prominent factor devastating bone tissue that is crucial to reestablishing in clinical. As we know, common symptom, osteoporosis, and infection limiting the ability of the bone tissue to recover cause difficulty before implantation therapy. Regeneration of bone tissue is the fundamental therapy before surgical processes. To promote the growth of bone tissue, many commercial products still have sophisticated problems that need to overcome. Regrettably, there is no available material which is apparently preferable for releasing and controlling of loading dosage, or mitigating inflammation. In our study, a hydrogel-based composite membrane has been prepared by using Gellan gum (GG), gamma-polyglutamic acid (γ-PGA) and glycerol with simple sol-gel method. GG is a natural material that is massively adopted in cartilage. Unfortunately, the strength of pure GG film is a manifest weakness especially under simulating body fluidic conditions. We utilize another biocompatible material, γ-PGA as cross-linker which can form tri-dimension structure that enhancing the strength. Our result indicated the strength of pure GG membrane can be obviously improved by cross-linked with γ-PGA (0.5, 0.6, 0.7, 0.8, 0.9, 1.0 w/v%). Besides, blending with glycerol (0, 1.0, 2.0, 3.0 w/v%) can significantly improve membrane toughness that corresponds to practical use. The innovative composited hydrogel made of GG, γ-PGA, and glycerol is attested with neat results including elongation and biocompatibility that take the advantage of extension covering major trauma. Recommendations are made for treatment to build up the foundation of bone tissue that would help patients to escape from the suffering and shorten the amount of time in recovery.

Keywords: bone tissue, gellan gum, regeneration, toughness

Procedia PDF Downloads 115
60 Turning Parameters Affect Time up and Go Test Performance in Pre-Frail Community-Dwelling Elderly

Authors: Kuei-Yu Chien, Hsiu-Yu Chiu, Chia-Nan Chen, Shu-Chen Chen

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Background: Frailty is associated with decreased physical performances that affect mobility of the elderly. Time up and go test (TUG) was the common method to evaluate mobility in the community. The purpose of this study was to compare the parameters in different stages of Time up and go test (TUG) and physical performance between pre-frail elderly (PFE) and non-frail elderly (NFE). We also investigated the relationship between TUG parameters and physical performance. Methods: Ninety-two community-dwelling older adults were as participants in this study. Based on Canadian Study of Health and Aging Clinical Frailty Scale, 22 older adults were classified as PFE (71.77 ± 6.05 yrs.) and 70 were classified as NFE (71.2 ± 5.02 yrs.). We performed body composition and physical performance, including balance, muscular strength/endurance, mobility, cardiorespiratory endurance, and flexibility. Results: Pre-frail elderly took significantly longer time than NFE in TUG test (p=.004). Pre-frail elderly had lower turning average angular velocity (p = .017), turning peak angular velocity (p = .041) and turning-stand to sit peak angular velocity (p = .037) than NFE. The turning related parameters related to open-eye stand on right foot, 30-second chair stand test, back scratch, and 2-min step tests. Conclusions: Turning average angular velocity, turning peak angular velocity and turning-stand to sit peak angular velocity mainly affected the TUG performance. We suggested that static/dynamic balance, agility, flexibility, and muscle strengthening of lower limbs exercise were important to PFE.

Keywords: mobility, aglity, active ageing, functional fitness

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59 The Cost-Effectiveness of High-Volume Hospital’s Surgical Care for Pancreatic Cancer: Economic Evidence Reviewed

Authors: Shannon Hearney, Jeffrey Hoch

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Pancreatic cancer is a notoriously costly and deadly form of cancer. Many types of treatment centers exist for patients to seek care from, including high-volume centers which have shown promise to provide the highest quality of care. While it may be true that this type of center provides the best care it is unclear if that care is cost-effective. Studies in the US have confirmed that high-volume hospitals do provide higher quality of care but have shown inconsistencies in the cost-effectiveness of that care. Other studies, like those from Finland have shown that high-volume centers had lower mortality and lower costs than low-volume centers. This paper thus seeks to review the current scientific literature to better understand if high-volume centers are cost-effective in delivering care in both a European setting and in the US. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

Procedia PDF Downloads 67
58 Four-Way Coupled CFD-Dem Simulation of Concrete Pipe Flow Using a Non-Newtonian Rheological Model: Investigating the Simulation of Lubrication Layer Formation and Plug Flow Zones

Authors: Tooran Tavangar, Masoud Hosseinpoor, Jeffrey S. Marshall, Ammar Yahia, Kamal Henri Khayat

Abstract:

In this study, a four-way coupled CFD-DEM methodology was used to simulate the behavior of concrete pipe flow. Fresh concrete, characterized as a biphasic suspension, features aggregates comprising the solid-suspended phase with diverse particle-size distributions (PSD) within a non-Newtonian cement paste/mortar matrix forming the liquid phase. The fluid phase was simulated using CFD, while the aggregates were modeled using DEM. Interaction forces between the fluid and solid particles were considered through CFD-DEM computations. To capture the viscoelastic characteristics of the suspending fluid, a bi-viscous approach was adopted, incorporating a critical shear rate proportional to the yield stress of the mortar. In total, three diphasic suspensions were simulated, each featuring distinct particle size distributions and a concentration of 10% for five subclasses of spherical particles ranging from 1 to 17 mm in a suspending fluid. The adopted bi-viscous approach successfully simulated both un-sheared (plug flow) and sheared zones. Furthermore, shear-induced particle migration (SIPM) was assessed by examining coefficients of variation in particle concentration across the pipe. These SIPM values were then compared with results obtained using CFD-DEM under the Newtonian assumption. The study highlighted the crucial role of yield stress in the mortar phase, revealing that lower yield stress values can lead to increased flow rates and higher SIPM across the pipe.

Keywords: computational fluid dynamics, concrete pumping, coupled CFD-DEM, discrete element method, plug flow, shear-induced particle migration.

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57 Study of Fork Marks on Sapphire Wafers in Plasma Enhanced Chemical Vapor Deposition Tool

Authors: Qiao Pei Wen, Ng Seng Lee, Sae Tae Veera, Chiu Ah Fong, Loke Weng Onn

Abstract:

Thin film thickness uniformity is crucial to get consistent film etch rate and device yield across the wafer. In the capacitive-coupled parallel plate PECVD system; the film thickness uniformity can be affected by many factors such as the heater temperature uniformity, the spacing between top and bottom electrode, RF power, pressure, gas flows and etc. In this paper, we studied how the PECVD SiN film thickness uniformity is affected by the substrate electrical conductivity and the RF power coupling efficiency. PECVD SiN film was deposited on 150-mm sapphire wafers in 200-mm Lam Sequel tool, fork marks were observed on the wafers. On the fork marks area SiN film thickness is thinner than that on the non-fork area. The forks are the wafer handler inside the process chamber to move the wafers from one station to another. The sapphire wafers and the ceramic forks both are insulator. The high resistivity of the sapphire wafers and the forks inhibits the RF power coupling efficiency during PECVD deposition, thereby reducing the deposition rate. Comparing between the high frequency and low frequency RF power (HFRF and LFRF respectively), the LFRF power coupling effect on the sapphire wafers is more dominant than the HFRF power on the film thickness. This paper demonstrated that the SiN thickness uniformity on sapphire wafers can be improved by depositing a thin TiW layer on the wafer before the SiN deposition. The TiW layer can be on the wafer surface, bottom or any layer before SiN deposition.

Keywords: PECVD SiN deposition, sapphire wafer, substrate electrical conductivity, RF power coupling, high frequency RF power, low frequency RF power, film deposition rate, thickness uniformity

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56 Willingness to Adopt "Green Steel" Products: A Case Study from the Automotive Sector

Authors: Hasan Muslemani, Jeffrey Wilson, Xi Liang, Francisco Ascui, Katharina Kaesehage

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This paper aims to examine consumer behaviour towards, and the willingness to adopt, green steel use in the automotive sector, in order to identify potential barriers and opportunities for its widespread adoption. Semi-structured interviews were held with experts from global, regional and country-specific industry associations and automakers. The analysis shows there is a new shift towards lifecycle thinking in the sector, although these efforts have been voluntary and driven by customer and employee pressures rather than regulation. The paper further appraises possible demand for green steel within different vehicle types (based on size and powertrain), and shows that manufacturers of electric heavy-duty vehicles are most likely to adopt green steel in the first instance, given the amount of incorporated steel in the vehicles and the fact that lifecycle emissions lie predominantly in their manufacturing phase. A case for green advanced higher-strength steels (AHSS) can also be made in light-duty passenger vehicles, which may mitigate competition from light-weight alternative materials in terms of cost and greenness (depending on source and utilisation zones). This work builds on a wide sustainability-related literature in the automotive sector and highlights areas in need of urgent action if the sector as a whole were to meet its Paris Agreement climate targets, in particular a need to revisit current CO2 performance regulations to include Scope 1 and Scope 2 emissions, engage in educational green marketing campaigns, and explore innovative market-based mechanisms to bridge the gap between relatively-low carbon abatement costs of steelmaking and high abatement costs of vehicle manufacturing.

Keywords: Green steel, Consumer behaviour, Automotive industry, Environmental sustainability

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55 Dietary N-6/N-3 PUFA Ratios Affect the Homeostasis of CD4+ T Cells in Mice with Dextran Sulfate Sodium-Induced Colitis

Authors: Cyoung-Huei Huang, Chiu-Li Yeh, Man-Hui Pai, Sung-Ling Yeh

Abstract:

This study evaluated the effect of different dietary n-6/n-3 polyunsaturated fatty acid (PUFA) ratios on modulating helper T (Th) and regulatory T (Treg) lymphocytes in mice with dextran sulfate sodium (DSS)-induced colitis. There were 3 control and 3 colitis groups in this study. Mice were fed for 24 d with an AIN-93G diet either with soybean oil (S), a mixture of soybean oil and low fish oil content (LF) or high fish oil content (HF). The ratio of n-6/n-3 PUFA in the LF diet was 4:1, and that in the HF diet was 2:1. The control groups drank distilled water while colitis groups provided 2% DSS in drinking water during day 15-19. All mice drank distilled water from day 20-24 for recovery and sacrificed on day 25. The results showed that colitis resulted in higher Th1, Th2, and Th17 and lower Treg percentages in the blood. Also, plasma haptoglobin and proinflammatory chemokines were elevated in colon lavage fluid. Colitic groups with fish oil had lower inflammatory mediators in the plasma and colon lavage fluid. Further, the percentages of Th1, Th2, and Th17 cells in the blood were lower, whereas Treg cell percentages were higher than those in the soybean oil group. The colitis group with n-6/n-3 PUFA ratio 2:1 had more pronounce effects than ratio 4:1. These results suggest that diets with an n-6/n-3 PUFA ratio of 2:1 or 4:1 regulate the Th/Treg balance and attenuate inflammatory mediator production in colitis. Compared to the n-6/n-3 PUFA ratio 4:1, the ratio of 2:1 was more effective in reducing inflammatory reactions in DSS-induced colitis.

Keywords: inflammatory bowel disease, n-3 polyunsaturated fatty acids, helper T lymphocyte, regulatory T lymphocyte

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54 Application of Particle Swarm Optimization to Thermal Sensor Placement for Smart Grid

Authors: Hung-Shuo Wu, Huan-Chieh Chiu, Xiang-Yao Zheng, Yu-Cheng Yang, Chien-Hao Wang, Jen-Cheng Wang, Chwan-Lu Tseng, Joe-Air Jiang

Abstract:

Dynamic Thermal Rating (DTR) provides crucial information by estimating the ampacity of transmission lines to improve power dispatching efficiency. To perform the DTR, it is necessary to install on-line thermal sensors to monitor conductor temperature and weather variables. A simple and intuitive strategy is to allocate a thermal sensor to every span of transmission lines, but the cost of sensors might be too high to bear. To deal with the cost issue, a thermal sensor placement problem must be solved. This research proposes and implements a hybrid algorithm which combines proper orthogonal decomposition (POD) with particle swarm optimization (PSO) methods. The proposed hybrid algorithm solves a multi-objective optimization problem that concludes the minimum number of sensors and the minimum error on conductor temperature, and the optimal sensor placement is determined simultaneously. The data of 345 kV transmission lines and the hourly weather data from the Taiwan Power Company and Central Weather Bureau (CWB), respectively, are used by the proposed method. The simulated results indicate that the number of sensors could be reduced using the optimal placement method proposed by the study and an acceptable error on conductor temperature could be achieved. This study provides power companies with a reliable reference for efficiently monitoring and managing their power grids.

Keywords: dynamic thermal rating, proper orthogonal decomposition, particle swarm optimization, sensor placement, smart grid

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53 Brown-Spot Needle Blight: An Emerging Threat Causing Loblolly Pine Needle Defoliation in Alabama, USA

Authors: Debit Datta, Jeffrey J. Coleman, Scott A. Enebak, Lori G. Eckhardt

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Loblolly pine (Pinus taeda) is a leading productive timber species in the southeastern USA. Over the past three years, an emerging threat is expressed by successive needle defoliation followed by stunted growth and tree mortality in loblolly pine plantations. Considering economic significance, it has now become a rising concern among landowners, forest managers, and forest health state cooperators. However, the symptoms of the disease were perplexed somewhat with root disease(s) and recurrently attributed to invasive Phytophthora species due to the similarity of disease nature and devastation. Therefore, the study investigated the potential causal agent of this disease and characterized the fungi associated with loblolly pine needle defoliation in the southeastern USA. Besides, 70 trees were selected at seven long-term monitoring plots at Chatom, Alabama, to monitor and record the annual disease incidence and severity. Based on colony morphology and ITS-rDNA sequence data, a total of 28 species of fungi representing 17 families have been recovered from diseased loblolly pine needles. The native brown-spot pathogen, Lecanosticta acicola, was the species most frequently recovered from unhealthy loblolly pine needles in combination with some other common needle cast and rust pathogen(s). Identification was confirmed using morphological similarity and amplification of translation elongation factor 1-alpha gene region of interest. Tagged trees were consistently found chlorotic and defoliated from 2019 to 2020. The current emergence of the brown-spot pathogen causing loblolly pine mortality necessitates the investigation of the role of changing climatic conditions, which might be associated with increased pathogen pressure to loblolly pines in the southeastern USA.

Keywords: brown-spot needle blight, loblolly pine, needle defoliation, plantation forestry

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52 Site-Specific Delivery of Hybrid Upconversion Nanoparticles for Photo-Activated Multimodal Therapies of Glioblastoma

Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

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51 Optimization of Mechanical Cacao Shelling Parameters Using Unroasted Cocoa Beans

Authors: Jeffrey A. Lavarias, Jessie C. Elauria, Arnold R. Elepano, Engelbert K. Peralta, Delfin C. Suministrado

Abstract:

Shelling process is one of the primary processes and critical steps in the processing of chocolate or any product that is derived from cocoa beans. It affects the quality of the cocoa nibs in terms of flavor and purity. In the Philippines, small-scale food processor cannot really compete with large scale confectionery manufacturers because of lack of available postharvest facilities that are appropriate to their level of operation. The impact of this study is to provide the needed intervention that will pave the way for cacao farmers of engaging on the advantage of value-adding as way to maximize the economic potential of cacao. Thus, provision and availability of needed postharvest machines like mechanical cacao sheller will revolutionize the current state of cacao industry in the Philippines. A mechanical cacao sheller was developed, fabricated, and evaluated to establish optimum shelling conditions such as moisture content of cocoa beans, clearance where of cocoa beans passes through the breaker section and speed of the breaking mechanism on shelling recovery, shelling efficiency, shelling rate, energy utilization and large nib recovery; To establish the optimum level of shelling parameters of the mechanical sheller. These factors were statistically analyzed using design of experiment by Box and Behnken and Response Surface Methodology (RSM). By maximizing shelling recovery, shelling efficiency, shelling rate, large nib recovery and minimizing energy utilization, the optimum shelling conditions were established at moisture content, clearance and breaker speed of 6.5%, 3 millimeters and 1300 rpm, respectively. The optimum values for shelling recovery, shelling efficiency, shelling rate, large nib recovery and minimizing energy utilization were recorded at 86.51%, 99.19%, 21.85kg/hr, 89.75%, and 542.84W, respectively. Experimental values obtained using the optimum conditions were compared with predicted values using predictive models and were found in good agreement.

Keywords: cocoa beans, optimization, RSM, shelling parameters

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50 Factors Related to Oncology Ward Nurses’ Job Stress Adaptation Needs in Southern Taiwan Regional Hospital

Authors: Minhui Chiu

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According to relevant studies, clinical nurses have high work pressure and relatively high job adaptation needs. The nurses who work in oncology wards have more adaptation needs when they face repeating hospitalization patients. The aims of this study were to investigate the job stress adaptation and related factors of nurses in oncology wards and to understand the predictors of job stress adaptation needs. Convenience sampling was used in this study. The nurses in the oncology specialist ward of a regional teaching hospital in southern Taiwan were selected as the research objects. A cross-sectional survey was conducted using a structured questionnaire, random sampling, and the questionnaires were filled out by the participating nurses. A total of 68 people were tested, and 65 valid questionnaires (95.6%). One basic data questionnaire and nurses’ job stress adaptation needs questionnaire were used. The data was archived with Microsoft Excel, and statistical analysis was performed with JMP12.0. The results showed that the average age was 28.8 (±6.7) years old, most of them were women, 62 (95.38%), and the average clinical experience in the hospital was 5.7 years (±5.9), and 62 (95.38%) were university graduates. 39 people (60.0%) had no work experience. 39 people (60.0%) liked nursing work very much, and 23 people (35.3%) just “liked”. 47 (72.3%) people were supported to be oncology nurses by their families. The nurses' job stress adaptation needs were 119.75 points (±17.24). The t-test and variance analysis of the impact of nurses' job pressure adaptation needs were carried out. The results showed that the score of college graduates was 121.10 (±16.39), which was significantly higher than that of master graduates 96.67 (±22.81), and the degree of liking for nursing work also reached a Significant difference. These two variables are important predictors of job adaptation needs, and the R Square is 24.15%. Conclusion: Increasing the love of clinical nurses in nursing and encouraging university graduation to have positive effects on job pressure adaptation needs and can be used as a reference for the management of human resources hospitals for oncology nurses.

Keywords: oncology nurse, job stress, job stress adaptation needs, manpower

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49 A Damage Level Assessment Model for Extra High Voltage Transmission Towers

Authors: Huan-Chieh Chiu, Hung-Shuo Wu, Chien-Hao Wang, Yu-Cheng Yang, Ching-Ya Tseng, Joe-Air Jiang

Abstract:

Power failure resulting from tower collapse due to violent seismic events might bring enormous and inestimable losses. The Chi-Chi earthquake, for example, strongly struck Taiwan and caused huge damage to the power system on September 21, 1999. Nearly 10% of extra high voltage (EHV) transmission towers were damaged in the earthquake. Therefore, seismic hazards of EHV transmission towers should be monitored and evaluated. The ultimate goal of this study is to establish a damage level assessment model for EHV transmission towers. The data of earthquakes provided by Taiwan Central Weather Bureau serve as a reference and then lay the foundation for earthquake simulations and analyses afterward. Some parameters related to the damage level of each point of an EHV tower are simulated and analyzed by the data from monitoring stations once an earthquake occurs. Through the Fourier transform, the seismic wave is then analyzed and transformed into different wave frequencies, and the data would be shown through a response spectrum. With this method, the seismic frequency which damages EHV towers the most is clearly identified. An estimation model is built to determine the damage level caused by a future seismic event. Finally, instead of relying on visual observation done by inspectors, the proposed model can provide a power company with the damage information of a transmission tower. Using the model, manpower required by visual observation can be reduced, and the accuracy of the damage level estimation can be substantially improved. Such a model is greatly useful for health and construction monitoring because of the advantages of long-term evaluation of structural characteristics and long-term damage detection.

Keywords: damage level monitoring, drift ratio, fragility curve, smart grid, transmission tower

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48 Opportunities and Challenges for Decarbonizing Steel Production by Creating Markets for ‘Green Steel’ Products

Authors: Hasan Muslemani, Xi Liang, Kathi Kaesehage, Francisco Ascui, Jeffrey Wilson

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The creation of a market for lower-carbon steel products, here called ‘green steel’, has been identified as an important means to support the introduction of breakthrough emission reduction technologies into the steel sector. However, the definition of what ‘green’ entails in the context of steel production, the implications on the competitiveness of green steel products in local and international markets, and the necessary market mechanisms to support their successful market penetration remain poorly explored. This paper addresses this gap by holding semi-structured interviews with international sustainability experts and commercial managers from leading steel trade associations, research institutes and steelmakers. Our findings show that there is an urgent need to establish a set of standards to define what ‘greenness’ means in the steelmaking context; standards that avoid market disruptions, unintended consequences, and opportunities for greenwashing. We also highlight that the introduction of green steel products will have implications on product competitiveness on three different levels: 1) between primary and secondary steelmaking routes, 2) with traditional, lesser green steel, and 3) with other substitutable materials (e.g. cement and plastics). This paper emphasises the need for steelmakers to adopt a transitional approach in deploying different low-carbon technologies, based on their stage of technological maturity, applicability in certain country contexts, capacity to reduce emissions over time, and the ability of the investment community to support their deployment. We further identify market mechanisms to support green steel production, including carbon border adjustments and public procurement, highlighting a need for implementing a combination of complementary policies to ensure the products’ roll-out. The study further shows that the auto industry is a likely candidate for green steel consumption, where a market would be supported by price premiums paid by willing consumers, such as those of high-end luxury vehicles.

Keywords: green steel, decarbonisation, business model innovation, market analysis

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47 Changing Emphases in Mental Health Research Methodology: Opportunities for Occupational Therapy

Authors: Jeffrey Chase

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Historically the profession of Occupational Therapy was closely tied to the treatment of those suffering from mental illness; more recently, and especially in the U.S., the percentage of OTs identifying as working in the mental health area has declined significantly despite the estimate that by 2020 behavioral health disorders will surpass physical illnesses as the major cause of disability worldwide. In the U.S. less than 10% of OTs identify themselves as working with the mentally ill and/or practicing in mental health settings. Such a decline has implications for both those suffering from mental illness and the profession of Occupational Therapy. One reason cited for the decline of OT in mental health has been the limited research in the discipline addressing mental health practice. Despite significant advances in technology and growth in the field of neuroscience, major institutions and funding sources such as the National Institute of Mental Health (NIMH) have noted that research into the etiology and treatment of mental illness have met with limited success over the past 25 years. One major reason posited by NIMH is that research has been limited by how we classify individuals, that being mostly on what is observable. A new classification system being developed by NIMH, the Research Domain Criteria (RDoc), has the goal to look beyond just descriptors of disorders for common neural, genetic, and physiological characteristics that cut across multiple supposedly separate disorders. The hope is that by classifying individuals along RDoC measures that both reliability and validity will improve resulting in greater advances in the field. As a result of this change NIH and NIMH will prioritize research funding to those projects using the RDoC model. Multiple disciplines across many different setting will be required for RDoC or similar classification systems to be developed. During this shift in research methodology OT has an opportunity to reassert itself into the research and treatment of mental illness, both in developing new ways to more validly classify individuals, and to document the legitimacy of previously ill-defined and validated disorders such as sensory integration.

Keywords: global mental health and neuroscience, research opportunities for ot, greater integration of ot in mental health research, research and funding opportunities, research domain criteria (rdoc)

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46 Use of Locally Effective Microorganisms in Conjunction with Biochar to Remediate Mine-Impacted Soils

Authors: Thomas F. Ducey, Kristin M. Trippe, James A. Ippolito, Jeffrey M. Novak, Mark G. Johnson, Gilbert C. Sigua

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The Oronogo-Duenweg mining belt –approximately 20 square miles around the Joplin, Missouri area– is a designated United States Environmental Protection Agency Superfund site due to lead-contaminated soil and groundwater by former mining and smelting operations. Over almost a century of mining (from 1848 to the late 1960’s), an estimated ten million tons of cadmium, lead, and zinc containing material have been deposited on approximately 9,000 acres. Sites that have undergone remediation, in which the O, A, and B horizons have been removed along with the lead contamination, the exposed C horizon remains incalcitrant to revegetation efforts. These sites also suffer from poor soil microbial activity, as measured by soil extracellular enzymatic assays, though 16S ribosomal ribonucleic acid (rRNA) indicates that microbial diversity is equal to sites that have avoided mine-related contamination. Soil analysis reveals low soil organic carbon, along with high levels of bio-available zinc, that reflect the poor soil fertility conditions and low microbial activity. Our study looked at the use of several materials to restore and remediate these sites, with the goal of improving soil health. The following materials, and their purposes for incorporation into the study, were as follows: manure-based biochar for the binding of zinc and other heavy metals responsible for phytotoxicity, locally sourced biosolids and compost to incorporate organic carbon into the depleted soils, effective microorganisms harvested from nearby pristine sites to provide a stable community for nutrient cycling in the newly composited 'soil material'. Our results indicate that all four materials used in conjunction result in the greatest benefit to these mine-impacted soils, based on above ground biomass, microbial biomass, and soil enzymatic activities.

Keywords: locally effective microorganisms, biochar, remediation, reclamation

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45 A Perspective on Emergency Care of Gunshot Injuries in Northern Taiwan

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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44 A Study on the Cultural Landscape of the Living Environment of Hoklo-Hakka: Case Study of Dacun

Authors: Meng-Li Lin, Shang-Hsuan Chiu

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Taiwan is a country of diverse ethnic groups, the historical background of each ethnic group is different, and the conflict between them influence on each other, result in Taiwan's multi-culture. The Changhua County in Taiwan is the largest county of Hoklo-Hakka. Hakka people get along with Hoklo people for a long time. There are integration and conflict during that time and makes Hakka people gradually assimilated Hoklo-Hakka people. Today in Changhua Plain area, many Hoklo-Hakka people do not speak Hakka language. Therefore, it has been difficult to find information of Hakka from the Hakka language in the group of Hoklo-Hakka. But in the living space or culture to find relevant historical traces of life could be confirmed in Hakka Culture. In this paper, through the investigation of descent, life field, religion, language and other investigations of the Dacun, Changhua County residents to carry out the analysis of the process of assimilating Hoklo in living cultural landscape. First is through the local literature, the elderly and other oral history stories, to investigate the changes in Dacun field historical. Second, the comparison of collected traditional Hakka culture and the living cultural landscape of Hoklo-Haka are done to explore the differences between the living cultural landscape and the traditional Hakka culture. After analysis Hoklo-Hakka living cultural landscape, the significant differences, we proposed preservation strategy to provide recommendations to save the cultural life of Hoklo-Hakka landscape in future. Changhua Dacun traditional Hakka landscape is disappearing, in this study, we explore and investigate the data of Changhua Dacun Hoklo-Hakka living cultural landscape to analyze and to provide strategic advice to save. Here we have three study purposes. 1. Discuss the Hoklo-Hakka living cultural landscape of Changhua Dacun. 2. Investigate and record the Hoklo-Hakka living cultural landscape. 3. Propose a reserve strategy of the Hoklo-Hakka living cultural landscape in future.

Keywords: Hoklo-Hakka, Dacun, save policy, life Culture

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43 Association between Levels of Volatile Organic Compound Metabolites and Cigarette Smoking-Related Urothelial Carcinoma

Authors: Chi-Jung Chung, Chao-Hsiang Chang, Chiu-Shong Liu, Sheng-Wei Li, Mu-Chi Chung, Ting-Jie Wen, Hui-Ling Lee

Abstract:

Cigarette smoke contains volatile organic compounds (VOCs), such as acrylamide, 1,3-butadiene, and benzene. This study aimed to explore the associations between the urinary levels of cotinine and VOC metabolites and the risk of urothelial carcinoma (UC). A hospital-based case–control study involving two groups matched on the basis of age ( ± 3 years) and gender was designed. UC was clinically diagnosed through urological examinations and pathologically verified. Smoking-related information was collected through questionnaires and face-to-face interviews with all study participants. Urine samples were collected for the analysis of the urinary levels of VOC metabolites, cotinine, and 8-hydroxydeoxygua- nosine (8-OHdG), which was selected as a proxy of oxidative stress. Multiple logistic regressions were applied to estimate the risk of UC. The urinary cotinine and 8-OHdG levels of the UC group were higher than those of the control group. The urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA), N- acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S- (4- hydroxy-2-buten-1-yl)-Lcysteine-3, trans, trans-muconic acid (t,t- MA), and S-phenylmercapturic acid (SPMA) increased as the urinary levels of cotinine increased. Relevant dose-response relationships between the risk of UC risk and the urinary levels of AAMA , t,t-MA, SPMA, and 8-OHdG were found after adjusting for potential risk factors. The UC risk of participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG were 3.5–6-fold higher than those of other participants. Increased urinary levels of VOC metabolites were associated with smoking-related UC risk. The development of UC should be explored in large-scale in vitro or in vivo studies with the repeated measurement of VOC metabolites.

Keywords: volatile organic compound, urothelial carcinoma, cotinine, 8-hydroxydeoxyguanosine

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42 Nursing Experience in Improving Physical and Mental Well-Being of a Patient with Premature Menopause Osteoporosis and Sarcopenia in Nursing-Led Multi-Discipline Care

Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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41 The Cost-Effectiveness of Pancreatic Surgical Cancer Care in the US vs. the European Union: Results of a Review of the Peer-Reviewed Scientific Literature

Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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