Search results for: Tsung Chieh Ma

Authors: Ng Wei Yan, Lim Jee Hock, Lee Foo Wei, Mo Kim Hung, Yip Chun Chieh

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The burgeoning accumulation of glass waste in Malaysia, particularly from the food and beverage industry, has become a prominent environmental concern, with disposal sites reaching saturation. This study introduces a distinct approach to addressing the twin challenges of landfill scarcity and natural resource conservation by repurposing discarded glass bottle waste into a viable construction material. The research presents a comprehensive evaluation of the strength characteristics of cement mortar when dark glass waste powder is used as a partial sand replacement. The experimental investigation probes the density, flow spread diameter, and key strength parameters—including compressive, splitting tensile, and flexural strengths—of the modified cement mortar. Remarkably, results indicate that a full replacement of sand with glass waste powder significantly improves the material's strength attributes. A specific mixture with a cement/sand/water ratio of 1:5:1.24 was found to be optimal, yielding an impressive compressive strength of 7 MPa at the 28-day mark, accompanied by a favourable 200 mm spread diameter in flow table tests. The findings of this study underscore the dual benefits of utilizing glass waste powder in cement mortar: mitigating Malaysia's glass waste dilemma and enhancing the performance of construction materials such as bricks and concrete products. Consequently, the research validates the premise that increasing the incorporation of glass waste as a sand substitute promotes not only environmental sustainability but also material innovation in the construction industry.

Keywords: glass waste, strength properties, cement mortar, environmental friendly

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Authors: Shih-Chieh Liao, Jen-Ying Ma

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Dual protagonists game always bring a unique experience compared to the other games. This research wants to discuss whether the dual protagonists have the moving ability and special ability or not; it will affect the preference of the players. This research will focus on the single-player dual protagonists game. After the observation, we found that when players control the dual protagonists, the moving ability and special ability are a great point defining the preference of players. When players control the character, which is lack of moving ability, they often feel impatient with the inconvenient mechanism and then reduce the will to play with the character or even the game. Furthermore, the special ability is also important in the situation that there is another character to compare with. When the character is too powerful, players tend not to use the weaker one. In addition, gender is a big deal in the games. It surprisingly controls the will of play occasionally. In view of these, this research makes a single-player dual protagonists game and the dual protagonists are limited to male and female. The experiment content detected with Electrodermal Activity (EDA) includes seven different situations. (1) male and females both have the moving ability and special ability. (2) male and female both have a special ability, but female does not have the moving ability. (3) male and females both have a special ability, but the male does not have the moving ability. (4) male and female both have the moving ability, but the male does not have special ability (5) male and female both have the moving ability, but female does not have a special ability (6) male-only has the moving ability and female-only has a special ability (7) male-only has a special ability and female only has the moving ability. The experiment will evaluate the emotional changes of the subjects in those situations. The result sorted by the significance of player preference is (6)>(4)>(1)>(2)>(5)>(3)>(7). The result demonstrates that players prefer females with special abilities or males with moving abilities. The game developer could design the ability of dual protagonists based on this research. Therefore, players may have a better experience.

Keywords: biofeedback, dual protagonists, emotional responses, psychology, user experience

Procedia PDF Downloads 159

Authors: Shun-Tong Chen, Wei-Ping Huang, Hong-Ye Yang, Ming-Chieh Yeh, Chih-Wei Du

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This study presents a novel versatile high-precision integrated micromachining system that combines contact and non-contact micromachining techniques to machine intricate micro-parts precisely. Two broad methods of micro fabrication-1) volume additive (micro co-deposition), and 2) volume subtractive (nanometric flycutting, ultrafine w-EDM (wire Electrical Discharge Machining), and micro honing) - are integrated in the developed micromachining system, and their effectiveness is verified. A multidirectional headstock that supports various machining orientations is designed to evaluate the feasibility of multifunctional micromachining. An exchangeable working-tank that allows for various machining mechanisms is also incorporated into the system. Hence, the micro tool and workpiece need not be unloaded or repositioned until all the planned tasks have been completed. By using the designed servo rotary mechanism, a nanometric flycutting approach with a concentric rotary accuracy of 5-nm is constructed and utilized with the system to machine a diffraction-grating element with a nano-metric scale V-groove array. To improve the wear resistance of the micro tool, the micro co-deposition function is used to provide a micro-abrasive coating by an electrochemical method. The construction of ultrafine w-EDM facilitates the fabrication of micro slots with a width of less than 20-µm on a hardened tool. The hardened tool can thus be employed as a micro honing-tool to hone a micro hole with an internal diameter of 200 µm on SKD-11 molded steel. Experimental results prove that intricate micro-parts can be in-situ manufactured with high-precision by the developed integrated micromachining system.

Keywords: integrated micromachining system, in-situ micromachining, nanometric flycutting, ultrafine w-EDM, micro honing

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Authors: Yu-Ting Tsai, Chiun-Chieh Hsu, Yu-Chun Chu

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In recent years, due to the development of wireless network technology, many researchers have devoted to the study of wireless sensor networks. The applications of wireless sensor network mainly use the sensor nodes to collect the required information, and send the information back to the users. Since the sensed area is difficult to reach, there are many restrictions on the design of the sensor nodes, where the most important restriction is the limited energy of sensor nodes. Because of the limited energy, researchers proposed a number of ways to reduce energy consumption and balance the load of sensor nodes in order to increase the network lifetime. In this paper, we proposed the Energy-Balanced Clustering method with Auxiliary Members on Wireless Sensor Networks（EBCAM）based on the cluster routing. The main purpose is to balance the energy consumption on the sensed area and average the distribution of dead nodes in order to avoid excessive energy consumption because of the increasing in transmission distance. In addition, we use the residual energy and average energy consumption of the nodes within the cluster to choose the cluster heads, use the multi hop transmission method to deliver the data, and dynamically adjust the transmission radius according to the load conditions. Finally, we use the auxiliary cluster members to change the delivering path according to the residual energy of the cluster head in order to its load. Finally, we compare the proposed method with the related algorithms via simulated experiments and then analyze the results. It reveals that the proposed method outperforms other algorithms in the numbers of used rounds and the average energy consumption.

Keywords: auxiliary nodes, cluster, load balance, routing algorithm, wireless sensor network

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Authors: Tzu-Hao Li, Shie-Liang Hsieh, Han-Chieh Lin, Ying-Ying Yang

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TNF superfamily-stimulated pathogenic cascades and macrophage (M1)/kupffer cells (KC) polarization are important in the pathogenesis of ischemia-reperfusion (IR) liver injury in animals with hepatic steatosis (HS). Decoy receptor 3 (DcR3) is a common upstream inhibitor of the above-mentioned pathogenic cascades. The study evaluated whether modulation of these DcR3-related cascades was able to protect steatotic liver from IR injury. Serum and hepatic DcR3 levels were lower in patients and animals with HS. Accordingly, the effects of pharmacologic and genetic DcR3 replacement on the IR-related pathogenic changes were measured. Significantly, DcR3 replacement protected IR-Zucker(HS) rats and IR-DcR3-Tg(HS) mice from IR liver injury. The beneficial effects of DcR3 replacement were accompanied by decreased serum/hepatic TNF, soluble TNF-like cytokine 1A (TL1A), Fas ligand (Fas-L) and LIGHT, T-helper-cell-1 cytokine (INF) levels, neutrophil infiltration, M1 polarization, neutrophil-macrophage/KC-T-cell interaction, hepatocyte apoptosis and improved hepatic microcirculatory failure among animals with IR-injured steatotic livers. Additionally, TL1A, Fas-L, LIGHT and TLR4/NFB signals were found to mediate the DcR3-related protective effects of steatotic livers from IR injury. Using multimodal in vivo and in vitro approaches, we found that DcR3 was a potential agent to protect steatotic livers from IR injury by simultaneous blocking the multiple IR injury-related pathogenic changes.

Keywords: Decoy 3 receptor, ischemia-reperfusion injury, M1 polarization, TNF superfamily

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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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

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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

Procedia PDF Downloads 403

Authors: Louise Moles, Steve Riley, Sarah D. Lichenstein, Marzieh Babaeianjelodar, Robert Kohler, Annie Cheng, Corey Horien Abigail Greene, Wenjing Luo, Jonathan Ahern, Bohan Xu, Yize Zhao, Chun Chieh Fan, R. Todd Constable, Sarah W. Yip

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Background: Risks for depression are myriad and include both genetic and brain-based factors. However, relationships between these systems are poorly understood, limiting understanding of disease etiology, particularly at the developmental level. Methods: We use a data-driven machine learning approach connectome-based predictive modeling (CPM) to identify functional connectivity signatures associated with polygenic risk scores for depression (DEP-PRS) among youth from the Adolescent Brain and Cognitive Development (ABCD) study across diverse brain states, i.e., during resting state, during affective working memory, during response inhibition, during reward processing. Results: Using 10-fold cross-validation with 100 iterations and permutation testing, CPM identified connectivity signatures of DEP-PRS across all examined brain states (rho’s=0.20-0.27, p’s<.001). Across brain states, DEP-PRS was positively predicted by increased connectivity between frontoparietal and salience networks, increased motor-sensory network connectivity, decreased salience to subcortical connectivity, and decreased subcortical to motor-sensory connectivity. Subsampling analyses demonstrated that model accuracies were robust across random subsamples of N’s=1,000, N’s=500, and N’s=250 but became unstable at N’s=100. Conclusions: These data, for the first time, identify neural networks of polygenic depression risk in a large sample of youth before the onset of significant clinical impairment. Identified networks may be considered potential treatment targets or vulnerability markers for depression risk.

Keywords: genetics, functional connectivity, pre-adolescents, depression

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

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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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Authors: Szu-Chieh Yu, Pei-Chin Chiand, Chih-Yi Lin, Yi-Wen Chien

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UV radiation from sunlight cause numbers of acute and chronic skin damage which can result in inflammation, immune changes, physical changes and DNA damage that facilitates skin aging and the development of skin carcinogenesis. Reactive oxygen species (ROS) are generated by excessive solar UV radiation, resulting in oxidative damage to cellar components, proteins, lipids, and nucleic acids. Thus, antioxidation plays an important role that protects skin against ROS-induced injury. Safflower (Carthamus tinctorius L.) is an important Chinese medicine contained abundance flavones and hydroxysafflor yellow A (HSYA) which is main active ingredient. HSYA is part of quinochalcone and has unique structures of hydroxy groups that provided the antioxidant effect. In this study, the aim was to investigate the protective role of HYSA in human keratinocytes (HaCaT) against UVA-induced oxidative damage and the possible mechanism. The HaCaT cells were UVA-irradiated and the effects of HYSA on cell viability, reactive oxygen species generation, DNA fragmentation and lipid peroxidation were measured. The mRNA expression of matrix metalloproteinase Ι (MMP Ι), cyclooxygenase-2 (COX-2) were determined by RT-PCR. In this study, UVA exposure lead to decrease in cell viability and increase in reactive oxygen species generation in HaCaT cells. HYSA could effectively increase the viability of HaCaT cells after UVA exposure and protect them from UVA-induced oxidative stress. Moreover, HYSA can reduce inflammation through inhibition the mRNA expression of MMP Ι and COX-2. Our results suggest that HSYA can act as a free radical scavenger while keratinocytes were photodamaged. HYSA could be a useful natural medicine for the protection of epidermal cells from UVA-induced damage and will be developed into products for skin care.

Keywords: HaCaT keratinocytes, hydroxysafflor yellow A (HSYA), MMP Ι, oxidative stress

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Authors: Yu-Chieh Chen, Li-Yun Wang, Chi-Chih Chen, Huy Hùng Đào, Ya-Mei Chen, Ming-Chu Cheng, Wen-Bin Chung, Hso-Chi Chaung, Guan-Ming Ke

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Many recent researches have demonstrated that CD154, a protein primarily expressed on activated T cell molecules, has potentially acted as a molecular adjuvant to improve the immunogenicity of subunit vaccines against viral infections. Classical swine fever (CSF) affects the swine industry worldwide that is one of the most devastating and highly contagious pig diseases. It is listed by the World Organization for Animal Health (OIE) as an infectious animal disease that must be reported. Although pigs vaccinated with subunit vaccines can be differentially diagnosed from those infected animals, subunit vaccines usually need adjuvants to enhance and elicit immune responses. In this study, CD154 was linked with CSFV E2 sequences and then expressed in CHO cells to produce the fusion protein as E2-CD154. The porcine specific CpG adjuvant was also used in one of the formulations. The specific pathogen-free pigs (SPF) at the age of 4-week-old were randomly separated into four groups, vaccinated with E2-CpG, E2-CD154, E2-CD154-CpG or the commercial Bayovac® CSF-E2 vaccine and boosted two weeks after primary vaccination. The results showed that the percentages of CD4+ and CD4+IL2+ in peripheral blood mononuclear cells (PBMC) in E2-CD154 vaccinated piglets seven days after primary vaccination were gained by 1-5% relative to the control group. In addition, the percentages of CD4+IFNγ+ T cells had slightly edged up 0.1-0.3% compared with the control group. Also, increased E2-specific IFNγ levels had edged up CD4+CD8+ T cells found in E2-CD154 and E2-CD154-CpG groups, particularly in the E2-CD154-CpG group. These results implicate that CD154 may enhance cellular immunity and synergistically act with species-specific CpG adjuvant as a dual-phase adjuvant. Therefore, the CD154 may be beneficial as a promising adjuvant in subunit vaccines.

Keywords: CD154, CpG adjuvant, cellular immunity, subunit vaccine, pig

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Authors: Shih-Tsung Chen, Yenchin Hsiao

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Evergreen Lily is a newly-built school after Morakot Typhoon took place. The school is located on Majia farm, which is surrounded by mountains. The fund in the construction of the school is solely sponsored by Chang Yung-Fa Foundation. There are 483 permanent houses near the school belonging to three tribes, Dashe, Majia, and Haocha. Due to the most ancient heritages of Paiwan and Rukai in these three tribes, the school is full of cultural atmosphere. From modern and traditional perspectives, Evergreen Lily strives to establish and develop a long-lasting educational model to meet the expectation of the tribes, parents, and the public. This study is a case study of how to develop indigenous education in newly established schools after the Morakot Hurricane disaster to meet the concept of environmental education. The systematic curriculum construction of education and cultural integration and the systematic practice of curriculum practice will be discussed, and the concept and practice of tribal education curriculum and sustainable environmental education will be understood. This study found that this school integrates the spirit of natural philosophy, democratic education, ethnic and experimental education, and constructs a knowledge system that includes three levels of spiritual culture, institutional culture, and material culture, as well as six dimensions of life philosophy, natural ecology, organizational system, tribal literature and history, song and dance, and technical and artistic methods. Adhering to the concept of harmonious education and the sustainable common good, the development of school-based tribal academic courses accounts for about one-third of the total number of teaching sessions, and there are different cultural themes in grades one to six, and there are clear teaching modules to effectively enhance students' potential inspiration. The complete curriculum implementation model can be described as a model for the development of indigenous schools to sustainable environmental education.

Keywords: environmental education, indigenous education, sustainable development, school-based curriculum

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Authors: Wei-Chieh Yeh, Yung-Tang Shen

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The concept of community building started in 1994 in Taiwan. After years of development, it fostered the notion of active local resident participation in community issues as co-operators, instead of minions. Participatory design gives participants more control in the decision-making process, helps to reduce the friction caused by arguments and assists in bringing different parties to consensus. This results in an increase in the efficiency of projects run in the community. Therefore, the participation of local residents is key to the success of community building. This study applied participatory design to develop plans for the reuse of deserted spaces in the community from the first stage of brainstorming for design ideas, making creative models to be employed later, through to the final stage of construction. After conducting a series of participatory designed activities, it aimed to integrate the different opinions of residents, develop a sense of belonging and reach a consensus. Besides this, it also aimed at building the residents’ awareness of their responsibilities for the environment and related issues of sustainable development. By reviewing relevant literature and understanding the history of related studies, the study formulated a theory. It took the “2012-2014 Changhua County Community Planner Counseling Program” as a case study to investigate the implementation process of participatory design. Research data are collected by document analysis, participants’ observation and in-depth interviews. After examining the three elements of “Design Participation”, “Construction Participation”, and” Follow–up Maintenance Participation” in the case, the study emerged with a promising conclusion: Maintenance works were carried out better compared to common public works. Besides this, maintenance costs were lower. Moreover, the works that residents were involved in were more creative. Most importantly, the community characteristics could be easy be recognized.

Keywords: participatory design, deserted space, community building, reuse

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Authors: Dar-Bin Shieh, Gwo-Bin Lee, Chen-Ming Chang, Chen Sheng Yeh, Chih-Chia Huang, Tsung-Ju Li

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Mitochondrial defects have a significant impact in many human diseases and aging associated phenotypes. The pathogenic mitochondrial DNA (mtDNA) mutations are diverse and usually present as heteroplasmic. mtDNA 4977bps deletion is one of the common mtDNA defects, and the ratio of mutated versus normal copy is significantly associated with clinical symptoms thus their quantitative detection has become an important unmet needs for advanced disease diagnosis and therapeutic guidelines. This study revealed a Micro-electro-mechanical-system (MEMS) enabled automatic microfluidic chip that only required minimal sample. The system integrated multiple laboratory operation steps into a Lab-on-a-Chip for high-sensitive and prompt measurement. The entire process including magnetic nanoparticle based mtDNA extraction in chip, mutation selective photonic DNA cleavage, and nanoparticle accelerated photonic quantitative polymerase chain reaction (qPCR). All subsystems were packed inside a miniature three-dimensional micro structured system and operated in an automatic manner. Integration of magnetic beads with microfluidic transportation could promptly extract and enrich the specific mtDNA. The near infrared responsive magnetic nanoparticles enabled micro-PCR to be operated by pulse-width-modulation controlled laser pulsing to amplify the desired mtDNA while quantified by fluorescence intensity captured by a complementary metal oxide system array detector. The proportions of pathogenic mtDNA in total DNA were thus obtained. Micro capillary electrophoresis module was used to analyze the amplicone products. In conclusion, this study demonstrated a new magnetophotonic based qPCR MEMS system that successfully detects and quantify specific disease related DNA mutations thus provides a promising future for rapid diagnosis of mitochondria diseases.

Keywords: mitochondrial DNA, micro-electro-mechanical-system, magnetophotonics, PCR

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Hung-Yuan Chang, Wen-Lung Chiang, Kuo-Liang Wu, Chen-Tsung Lin

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National Space Organization (NSPO) has completed in 2014 the development of a space-borne GPS receiver, including design, manufacture, comprehensive functional test, environmental qualification test and so on. The main performance of this receiver include 8-meter positioning accuracy, 0.05 m/sec speed-accuracy, the longest 90 seconds of cold start time, and up to 15g high dynamic scenario. The receiver will be integrated in the autonomous FORMOSAT-7 NSPO-Built satellite scheduled to be launched in 2019 to execute pre-defined scientific missions. The flight model of this receiver manufactured in early 2015 will pass comprehensive functional tests and environmental acceptance tests, etc., which are expected to be completed by the end of 2015. The space-borne GPS receiver is a pure software design in which all GPS baseband signal processing are executed by a digital signal processor (DSP), currently only 50% of its throughput being used. In response to the booming global navigation satellite systems, NSPO will gradually expand this receiver to become a multi-mode, multi-band, high-precision navigation receiver, and even a science payload, such as the reflectometry receiver of a global navigation satellite system. The fundamental purpose of this extension study is to port some software algorithms such as signal acquisition and correlation, reused code and large amount of computation load to the FPGA whose processor is responsible for operational control, navigation solution, and orbit propagation and so on. Due to the development and evolution of the FPGA is pretty fast, the new system architecture upgraded via an FPGA should be able to achieve the goal of being a multi-mode, multi-band high-precision navigation receiver, or scientific receiver. Finally, the results of tests show that the new system architecture not only retains the original overall performance, but also sets aside more resources available for future expansion possibility. This paper will explain the detailed DSP/FPGA architecture, development, test results, and the goals of next development stage of this receiver.

Keywords: space-borne, GPS receiver, DSP, FPGA, multi-mode multi-band

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Shih-Chieh Liao, Cheng-Yan Shuai

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"Party game" is a game mode that enables players to maintain a good social and interactive experience. The common game modes include Teamwork, Team competitive, Independent competitive, Battle Royale. Party games are defined as a game with easy rules, easy to play, quickly spice up a party, and support four to six players. It also needs to let the player feel satisfied no matter victory or defeat. However, players may feel negative or angry when the game is imbalanced, especially when they play with teammates. Some players care about winning or losing, and they will blame it on the game mechanics. What is more serious is that the player will cause the argument, which is unnecessary. These behaviors that trigger quarrels and negative emotions often originate from the player's determination of the victory and the ratio of victory during the competition. In view of this, our research invited a group of subjects to the experiment, which is going to inspect player’s emotions by Electromyography (EMG) and Electrodermal Activity (EDA) when they are playing party games with others. When a player wins or loses, the negative and positive feeling will be recorded from the game beginning to the end. At the same time, physiologic and emotional reactions are also being recorded in each part of the game. The game will be designed as telling the interaction when players are in the quest of a party game. The experiment content includes the emotional changes affected by the physiological values of game victory and defeat between “player against friend” and “player against stranger.” Through this experiment, the balance between winners and losers lies in the basis of good game interaction and game interaction in the game and explore the emotional positive and negative effects caused by the result of the party game. The result shows that “player against friend” has a significant negative emotion and significant positive emotion at “player against stranger.” According to the result, the player's experience will be affected with winning rate or form when they play the party game. We suggest the developer balance the game with our experiment method to let players get a better experience.

Keywords: party games, biofeedback, emotional responses, user experience, game design

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Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin

Abstract:

Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.

Keywords: activities of daily living, hand function, robotic rehabilitation, stroke

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Authors: Hung-Chieh Chen, Kuo-Hui Wang, Tsu-Lin Yeh

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Proteomics represent the performance of genomic complement proteins and the protein level on functional genomics. This study adopted proteomic strategies for comparing serum proteins among three groups: elite sprinter (sprint runner group, SR), long-distance runners (long-distance runner group, LDR), and the untrained control group (control group, CON). Purposes: This study aims to identify elite sprinters and long-distance runners’ serum protein and to provide a comparison of their serum proteome’ composition. Methods: Serum protein fractionations that separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and analyzed by a quantitative nano-LC-MS/MS-based proteomic profiling. The one-way analysis of variance (ANOVA) and Scheffe post hoc comparison (α= 0.05) was used to determine whether there is any significant difference in each protein level among the three groups. Results: (1) After analyzing the 307 identified proteins, there were 26 unique proteins in the SR group, and 18 unique proteins in the LDR group. (2) For the LDR group, 7 coagulation function-associated proteins’ expression levels were investigated: vitronectin, serum paraoxonase/arylesterase 1, fibulin-1, complement C3, vitamin K-dependent protein, inter-alpha-trypsin inhibitor heavy chain H3 and von Willebrand factor, and the findings show the seven coagulation function-associated proteins were significantly lower than the group of SR. (3) Comparing to the group of SR, this study found that the LDR group’s expression levels of the 2 antioxidant proteins (afamin and glutathione peroxidase 3) were also significantly lower. (4) The LDR group’s expression levels of seven immune function-related proteins (Ig gamma-3 chain C region, Ig lambda-like polypeptide 5, clusterin, complement C1s subcomponent, complement factor B, complement C4-A, complement C1q subcomponent subunit A) were also significantly lower than the group of SR. Conclusion: This study identified the potential serum protein markers for elite sprinters and long-distance runners. The changes in the regulation of coagulation, antioxidant, or immune function-specific proteins may also provide further clinical applications for these two different track athletes.

Keywords: biomarkers, coagulation, immune response, oxidative stress

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Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan

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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.

Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents

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Authors: Fen-Ling Kuo, Hsin-Chieh Lee, Han-Yun Hsiao, Jui-Chi Lin

Abstract:

Background: Children with cerebral palsy (CP) usually suffered from mild to maximum upper limb dysfunction such as having difficulty in reaching and picking up objects, which profoundly affects their participation in activities of daily living (ADLs). Robot-assisted rehabilitation provides intensive physical training in improving sensorimotor function of the hand. Many researchers have extensively studied the effects of robot-assisted therapy (RT) for the paretic upper limb in patients with stroke in recent years. However, few studies have examined the effect of RT on hand function in children with CP. The purpose of this study is to investigate the effectiveness of Gloreha Sinfonia, a robotic device with a dynamic arm support system mainly focus on distal upper-limb training, on improvements of hand function and ADLs in children with CP. Methods: Seven children with moderate CP were recruited in this case series study. RT using Gloreha Sinfonia was performed 2 sessions per week, 60 min per session for 6 consecutive weeks, with 12 times in total. Outcome measures included the Fugl-Meyer Assessment-upper extremity (FMA-UE), the Box and Block Test, the electromyography activity of the extensor digitorum communis muscle (EDC) and brachioradialis (BR), a grip dynamometer for motor evaluation, and the ABILHAND-Kids for measuring manual ability to manage daily activities, were performed at baseline, after 12 sessions (end of treatment) and at the 1-month follow-up. Results: After 6 weeks of robot-assisted treatment of hand function, there were significant increases in FMA-UE shoulder/elbow scores (p=0.002), FMA-UE wrist/hand scores (p=0.002), and FMA-UE total scores (p=0.002). There were also significant improvements in the BR mean value (p = 0.015) and electrical agonist-antagonist muscle ratio (p=0.041) in grasping a 1-inch cube task. These gains were maintained for a month after the end of the intervention. Conclusion: RT using Gloreha Sinfonia for hand function training may contribute toward the improvement of upper extremity function and efficacy in recruiting BR muscle in children with CP. The results were maintained at one month after intervention.

Keywords: activities of daily living, cerebral palsy, hand function, robotic rehabilitation

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Authors: Chia-Chen Wu, Chih-Fu Wu, Pey-Weng Lien, Kai-Chieh Lin

Abstract:

In the past, the most comprehensively adopted light source was incandescent light bulbs, but with the appearance of LED light sources, traditional light sources have been gradually replaced by LEDs because of its numerous superior characteristics. However, many of the standards do not apply to LEDs as the two light sources are characterized differently. This also intensifies the significance of studies on LEDs. As a Kansei design study investigating the visual glare produced by traffic arrows implemented with LEDs, this study conducted a semantic analysis on the styles of traffic arrows used in domestic and international occasions. The results will be able to reduce drivers’ misrecognition that results in the unsuccessful arrival at the destination, or in traffic accidents. This study started with a literature review and surveyed the status quo before conducting experiments that were divided in two parts. The first part involved a screening experiment of arrow samples, where cluster analysis was conducted to choose five representative samples of LED displays. The second part was a semantic experiment on the display of arrows using LEDs, where the five representative samples and the selected ten adjectives were incorporated. Analyzing the results with Quantification Theory Type I, it was found that among the composition of arrows, fletching was the most significant factor that influenced the adjectives. In contrast, a “no fletching” design was more abstract and vague. It lacked the ability to convey the intended message and might bear psychological negative connotation including “dangerous,” “forbidden,” and “unreliable.” The arrow design consisting of “> shaped fletching” was found to be more concrete and definite, showing positive connotation including “safe,” “cautious,” and “reliable.” When a stimulus was placed at a farther distance, the glare could be significantly reduced; moreover, the visual evaluation scores would be higher. On the contrary, if the fletching and the shaft had a similar proportion, looking at the stimuli caused higher evaluation at a closer distance. The above results will be able to be applied to the design of traffic arrows by conveying information definitely and rapidly. In addition, drivers’ safety could be enhanced by understanding the cause of glare and improving visual recognizability.

Keywords: LED, arrow, Kansei research, preferred imagery

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Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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Authors: Yi-Chun Kuo, Jo-Chieh Lin

Abstract:

The objective of a supply chain strategy is to reduce waste and increase efficiency to attain cost benefits, and to guarantee supply chain flexibility when facing the ever-changing market environment in order to meet customer requirements. Strategy implementation aims to fulfill common goals and attain benefits by integrating upstream and downstream enterprises, sharing information, conducting common planning, and taking part in decision making, so as to enhance the overall performance of the supply chain. With the rise of outsourcing and globalization, the increasing dependence on suppliers and customers and the rapid development of information technology, the complexity and uncertainty of the supply chain have intensified, and supply chain vulnerability has surged, resulting in adverse effects on supply chain performance. Thus, this study aims to use supply chain vulnerability as a moderating variable and apply structural equation modeling (SEM) to determine the relationships among supply chain strategy, supply chain integration, and supply chain performance, as well as the moderating effect of supply chain vulnerability on supply chain performance. The data investigation of this study was questionnaires which were collected from the management level of enterprises in Taiwan and China, 149 questionnaires were received. The result of confirmatory factor analysis shows that the path coefficients of supply chain strategy on supply chain integration and supply chain performance are positive (0.497, t= 4.914; 0.748, t= 5.919), having a significantly positive effect. Supply chain integration is also significantly positively correlated to supply chain performance (0.192, t = 2.273). The moderating effects of supply chain vulnerability on supply chain strategy and supply chain integration to supply chain performance are significant (7.407; 4.687). In Taiwan, 97.73% of enterprises are small- and medium-sized enterprises (SMEs) focusing on receiving original equipment manufacturer (OEM) and original design manufacturer (ODM) orders. In order to meet the needs of customers and to respond to market changes, these enterprises especially focus on supply chain flexibility and their integration with the upstream and downstream enterprises. According to the observation of this research, the effect of supply chain vulnerability on supply chain performance is significant, and so enterprises need to attach great importance to the management of supply chain risk and conduct risk analysis on their suppliers in order to formulate response strategies when facing emergency situations. At the same time, risk management is incorporated into the supply chain so as to reduce the effect of supply chain vulnerability on the overall supply chain performance.

Keywords: supply chain integration, supply chain performance, supply chain vulnerability, structural equation modeling

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Authors: Kai-Chieh Lin, Chih-Fu Wu, Hsiang Ling Hsu, Yung-Hsiang Tu, Chia-Chen Wu

Abstract:

With the rapid development of computer technology, the design of computers and keyboards moves towards a trend of slimness. The change of mobile input devices directly influences users’ behavior. Although multi-touch applications allow entering texts through a virtual keyboard, the performance, feedback, and comfortableness of the technology is inferior to traditional keyboard, and while manufacturers launch mobile touch keyboards and projection keyboards, the performance has not been satisfying. Therefore, this study discussed the design factors of slim pressure-sensitive keyboards. The factors were evaluated with an objective (accuracy and speed) and a subjective evaluation (operability, recognition, feedback, and difficulty) depending on the shape (circle, rectangle, and L-shaped), thickness (flat, 3mm, and 6mm), and force (35±10g, 60±10g, and 85±10g) of the keyboard. Moreover, MANOVA and Taguchi methods (regarding signal-to-noise ratios) were conducted to find the optimal level of each design factor. The research participants, by their typing speed (30 words/ minute), were divided in two groups. Considering the multitude of variables and levels, the experiments were implemented using the fractional factorial design. A representative model of the research samples were established for input task testing. The findings of this study showed that participants with low typing speed primarily relied on vision to recognize the keys, and those with high typing speed relied on tactile feedback that was affected by the thickness and force of the keys. In the objective and subjective evaluation, a combination of keyboard design factors that might result in higher performance and satisfaction was identified (L-shaped, 3mm, and 60±10g) as the optimal combination. The learning curve was analyzed to make a comparison with a traditional standard keyboard to investigate the influence of user experience on keyboard operation. The research results indicated the optimal combination provided input performance to inferior to a standard keyboard. The results could serve as a reference for the development of related products in industry and for applying comprehensively to touch devices and input interfaces which are interacted with people.

Keywords: input performance, mobile device, slim keyboard, tactile feedback

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Authors: Guan-Ying Chen, Han-Tsung Liou, Shou-Ren Hu

Abstract:

To address traffic congestion problems and encourage the use of public transportation systems in the Taipei metropolitan area, the Taipei City Government and the New Taipei City Government implemented a monthly ticket policy on April 16, 2018. This policy offers unlimited rides on the Taipei MRT, Taipei City Bus, New Taipei City Bus, Danhai Light Rail, and Public Bike (YouBike) on a monthly basis. Additionally, both city governments replaced the smart card discount policy with a new frequent flyer discount program (referred to as the loyal customer program) on February 1, 2020, introducing a differential pricing policy. Specifically, the more frequently the Taipei MRT system is used, the greater the discounts users receive. To analyze the impact of the Taipei public transport monthly ticket policy and the frequent user discount program on the passenger volume of the Taipei MRT system and the transferring behaviors of MRT users, this study conducts a trip-chain analysis using transaction data from Taipei MRT smart cards between September 2017 and December 2020. To achieve these objectives, the study employs four indicators: 1) number of passengers, 2) average number of rides, 3) average trip distance, and 4) instances of multiple consecutive rides. The study applies the t-test and Mann-Kendall trend test to investigate whether the proposed indicators have changed over time due to the implementation of the discount policy. Furthermore, the study examines the travel behaviors of passengers who use monthly tickets. The empirical results of the study indicate that the implementation of the Taipei public transport monthly ticket policy has led to an increase in the average number of passengers and a reduction in the average trip distance. Moreover, there has been a significant increase in instances of multiple consecutive rides, attributable to the unlimited rides offered by the monthly tickets. The impact of the frequent user discount program on changes in MRT passengers is not as pronounced as that of the Taipei public transportation monthly ticket policy. This is partly due to the fact that the frequent user discount program is only applicable to the Taipei MRT system, and the passenger volume was greatly affected by the COVID-19 pandemic. The findings of this research can serve as a reference for Taipei MRT Corporation in formulating its fare strategy and can also provide guidance for the Taipei and New Taipei City Governments in evaluating differential pricing policies for public transportation systems.

Keywords: frequent user discount program, mass rapid transit, monthly ticket, smart card

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Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

Abstract:

Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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Authors: Pei-Ying Lo, Jing-Hao Ciou, Kai-Cheng Yang, Jia-Huei Zheng, Shih-Hsiang Huang, Kuen-Chan Lee, Er-Chieh Cho

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As-produced CNTs are insoluble in all organic solvents and aqueous solutions have imposed limitations to the use of CNTs. Therefore, how to debundle carbon nanotubes and to modify them for further uses is an important issue. There are several methods for the dispersion of CNTs in water using covalent attachment of hydrophilic groups to the surface of tubes. These methods, however, alter the electronic structure of the nanotubes by disrupting the network of sp2 hybridized carbons. In order to keep the nanotubes’ intrinsic mechanical and electrical properties intact, non-covalent interactions are increasingly being explored as an alternative route for dispersion. Apart from conventional surfactants such as sodium dodecylsulfate (SDS) or sodium dodecylbenzenesulfonate (SDBS) which are highly effective in dispersing CNTs, biopolymers have received much attention as dispersing agents due to the anticipated biocompatibility of the dispersed CNTs. Also, The pyrenyl group is known to interact strongly with the basal plane of graphene via π-stacking. In this study, a highly re-dispersible biopolymer is reported for the synthesis of pyrene-modified poly-L-lysine (PBPL) and poly(D-Glu, D-Lys) (PGLP). To provide the evidence of the safety of the PBPL/CNT & PGLP/CNT materials we use in this study, H1299 and HCT116 cells were incubated with PBPL/CNT & PGLP/CNT materials for toxicity analysis, MTS assays. The results from MTS assays indicated that no significant cellular toxicity was shown in H1299 and HCT116 cells. Furthermore, the fluorescence marker fluorescein isothiocyanate (FITC) was added to PBPL & PGLP dispersions. From the fluorescent measurements showed that the chemical functionalisation of the PBPL/CNT & PGLP/CNT conjugates with the fluorescence marker were successful. The fluorescent PBPL/CNT & PGLP/CNT conjugates could find application in medical imaging. In the next step, the GFP gene is immobilized onto PBPL/CNT conjugates by introducing electrostatic interaction. GFP-transfected cells that emitted fluorescence were imaged and counted under a fluorescence microscope. Due to the unique biocompatibility of PBPL modified CNTs, the GFP gene could be transported into H1299 cells without using antibodies. The applicability of such soluble and chemically functionalised polypeptide/CNT conjugates in biomedicine is currently investigated. We expect that this polypeptide/CNT system will be a safe and multi-functional nanomedical delivery platform and contribute to future medical therapy.

Keywords: carbon nanotube, nanotoxicology, GFP transfection, polypeptide/CNT hybrids

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Authors: Yun-Shan Tsai, Si-Ping Lin, En-Chieh Lin, Xin-Hong Chen, Shin-Yun Ho, Shin-Hong Huang, Ching-ju Hsieh

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Background and significance: Uncorrected refractive errors and cataracts are the main visually debilitating ophthalmological abnormalities in adult participants with intellectual disability (ID). However, not all adult participants with ID may receive a regular and timely ophthalmological assessment. Consequently, some of the ocular diseases may not be diagnosed until late, thereby causing unnecessary ocular morbidity. In addition, recent clinical practice and researches have also suggested that eye-care services for this group are neglected. Purpose: To investigate the unmet need for eye care services, clinical characteristics of cataract, visual function, surgical outcome and prognostic predictors in adult participants with ID at Taipei City Hospital in Taiwan. Methods: This is a one-year prospective clinical study. We recruited about 120 eyes of 60 adult participants with ID who were received cataract surgery. Caregivers of all participants received a questionnaire on current eye care services. Clinical demographic data, such as age, gender, and associated systemic diseases or syndromes, were collected. All complete ophthalmologic examinations were performed 1 month preoperatively and 3 months postoperatively, including ocular biometry, visual function, refractive status, morphology of cataract, associated ocular features, anesthesia methods, surgical types, and complications. Morphology of cataract, visual and surgical outcome was analyzed. Results: A total of 60 participants with mean age 43.66 ± 13.94 years, including 59.02% male and 40.98% female, took part in comprehensive eye-care services. The prevalence of unmet need for eye care services was high (about 70%). About 50% of adult participants with ID have bilateral cataracts at the time of diagnosis. White cataracts were noted in about 30% of all adult participants with ID at the time of presentation. Associated ocular disorders were included myopic maculopathy (4.54%), corneal disorders (11.36%), nystagmus (20.45%), strabismus (38.64%) and glaucoma (2.27%). About 26.7% of adult participants with ID underwent extracapsular cataract extraction whereas a phacoemulsification was performed in 100% of eyes. Intraocular lens implantation was performed in all eyes. The most common postoperative complication was posterior capsular opacification (30%). The mean best-corrected visual acuity was significantly improved from preoperatively (mean log MAR 0.48 ± 0.22) to at 3 months postoperatively (mean log MAR 0.045 ± 0.22) (p < .05). Conclusions: Regular follow up will help address the need for eye-care services in participants with ID. A high incidence of bilateral cataracts, as well as white cataracts, was observed in adult participants with ID. Because of early diagnosis and early intervention of cataract, the visual and surgical outcomes of cataract are good, but the visual outcomes are suboptimal due to associated ocular comorbidities.

Keywords: adult participants with intellectual disability, cataract, cataract surgery

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