Exploring the Use Patterns of a Mobile Health Application for Alcohol Addiction before the Initial Lapse after Detoxification

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS), a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial lapse), the active users (with the lowest chance of such behavior) participated more in online social activities, used more sessions, viewed more pages, and used A-CHESS longer. However, the chances of the initial lapse between A-CHESS user profiles were not statistically different. Implications of this finding were provided

Case Experience of Radiofrequency Ablation for Benign Thyroid Nodules: From an Ex Vivo Animal Study to an Initial Ablation in Taiwan

AbstractRadiofrequency ablation (RFA) is a minimally invasive technique, used with ultrasound or computed tomography guidance, which can produce tissue coagulation necrosis in various kinds of tumors in the human body. In the past 10 years, numerous studies about RFA in benign thyroid nodules have been published. Reviewing these studies, we noticed that the effectiveness of ablation was higher when it was performed with the “moving-shot technique” via an internally cooled electrode. A consensus statement published from the Korean Society of Radiology also suggested the moving-shot technique as a standard ablation procedure for benign thyroid nodule ablation in Korea. In Taiwan, most symptomatic benign nodules are currently treated with surgical removal. RFA for mass lesions is primarily performed for the treatment of metastatic hepatic tumors. In our case, we have attempted to introduce RFA for benign thyroid nodules in Taiwan. Because endocrinologists in Taiwan were not familiar with this technique, we adopted a stepwise approach in learning how to perform RFA. We conducted ex vivo animal ablation exercises to gain experience in setting the radiofrequency generator for the right ablation mode and appropriate power output. The thyroid nodule volume reduction rate after 1 year of follow up was approximately 50% in this case. The most important thing we learned from this trial is that we confirmed the safety of thyroid nodule ablation. To the best of our knowledge, this is the first reported study of RFA of a thyroid nodule in Taiwan

Particles Separation and Tracks in a Hydrocyclone

100學年度研究獎補助論文[[abstract]]Hydrocyclone separation technique recently has been used in an increasing number of applications. Reynolds Stress Turbulence Model (RSM) and Discrete Phase Model (DPM) were employed in Computational Fluid Dynamics (CFD) 3D simulation to draw the motion trace of single particle of different particle size and density in hydrocyclone separator. It is known that, smaller size particles flow out from overflow, larger size particles flow out from underflow, and there is a characteristic size of particles having longer residence time in hydrocyclone separator. Particle size influences separation efficiency more significantly than particle density. Simulation of particle cluster separation efficiency in hydrocyclone separator has some discrepancy from experimental result. It is because air core influence is not considered in this study.[[notice]]補正完畢[[incitationindex]]EI[[booktype]]紙

A Structural Equation Model for Consumers’ Mobile-based Information Search: A Case of Outbound Chinese Tourists

This research responds to the call for more studies to validate a comprehensive model incorporating mobile Internet and other information channels to investigate their effects within the search process. Using 104 Chinese outbound tourists as the sample, this study investigates how they utilize multiple sources for trip planning. The research findings indicate that mobile-based search actions have been undertaken step by step: internal search mobile search preliminary collaborative TIS saving information summarizing information. Two search patterns were identified by using other information sources: 1. mobile Internet advanced collaborative TIS editorial communications; 2. mobile Internet PC Internet editorial communications. In spite of the studys limitations in relation to generalizing the results, this study presents new avenues for further research

A New Combined Boost Converter with Improved Voltage Gain as a Battery-Powered Front-End Interface for Automotive Audio Amplifiers

High boost DC/DC voltage conversion is always indispensable in a power electronic interface of certain battery-powered electrical equipment. However, a conventional boost converter works for a wide duty cycle for such high voltage gain, which increases power consumption and has low reliability problems. In order to solve this issue, a new battery-powered combined boost converter with an interleaved structure consisting of two phases used in automotive audio amplifier is presented. The first phase uses a conventional boost converter; the second phase employs the inverted type. With this architecture, a higher boost voltage gain is able to be achieved. A derivation of the operating principles of the converter, analyses of its topology, as well as a closed-loop control designs are performed in this study. Furthermore, simulations and experiments are also performed using input voltage of 12 V for a 120Wcircuit. A reasonable duty cycle is selected to reach output voltage of 60 V, which corresponds to static voltage gain of five. The converter achieves a maximum measured conversion efficiency of 98.7% and the full load efficiency of 89.1%

A Smartphone-Based Support Group for Alcoholism: Effects of Giving and Receiving Emotional Support on Coping Self-Efficacy and Risky Drinking

The purpose of this study was to investigate the nature and effects of exchanging emotional support via a smartphone-based support group for patients with alcohol dependence. Of the 349 patients who met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for alcohol dependence, 153 patients participated in the discussion group within the Addiction-Comprehensive Health Enhancement Support System, a smartphone application aimed at reducing relapse. This was developed to prevent problem drinking by offering individuals in recovery for alcohol dependence automated 24/7 recovery support services and frequent assessment of their symptom status as part of their addiction care. The results showed that receiving emotional support from health care providers improved coping self-efficacy. Giving emotional support and receiving emotional support from health care providers acted as a buffer, protecting patients from the harmful effects of emotional distress on risky drinking. Clinicians and researchers should use the features of smartphone-based support groups to reach out to alcoholic patients in need and encourage them to participate in the exchange of emotional support with others

The Hard-Constraint PINNs for Interface Optimal Control Problems

We show that the physics-informed neural networks (PINNs), in combination with some recently developed discontinuity capturing neural networks, can be applied to solve optimal control problems subject to partial differential equations (PDEs) with interfaces and some control constraints. The resulting algorithm is mesh-free and scalable to different PDEs, and it ensures the control constraints rigorously. Since the boundary and interface conditions, as well as the PDEs, are all treated as soft constraints by lumping them into a weighted loss function, it is necessary to learn them simultaneously and there is no guarantee that the boundary and interface conditions can be satisfied exactly. This immediately causes difficulties in tuning the weights in the corresponding loss function and training the neural networks. To tackle these difficulties and guarantee the numerical accuracy, we propose to impose the boundary and interface conditions as hard constraints in PINNs by developing a novel neural network architecture. The resulting hard-constraint PINNs approach guarantees that both the boundary and interface conditions can be satisfied exactly and they are decoupled from the learning of the PDEs. Its efficiency is promisingly validated by some elliptic and parabolic interface optimal control problems

The Use of External Change Agents to Promote Quality Improvement and Organizational Change in Healthcare Organizations: A Systematic Review

Background: External change agents can play an essential role in healthcare organizational change efforts. This systematic review examines the role that external change agents have played within the context of multifaceted interventions designed to promote organizational change in healthcare-specifically, in primary care settings. Methods: We searched PubMed, CINAHL, Cochrane, Web of Science, and Academic Search Premier Databases in July 2016 for randomized trials published (in English) between January 1, 2005 and June 30, 2016 in which external agents were part of multifaceted organizational change strategies. The review was conducted according to PRISMA guidelines. A total of 477 abstracts were identified and screened by 2 authors. Full text articles of 113 studies were reviewed. Twenty-one of these studies were selected for inclusion. Results: Academic detailing (AD) is the most prevalently used organizational change strategy employed as part of multi-component implementation strategies. Out of 21 studies, nearly all studies integrate some form of audit and feedback into their interventions. Eleven studies that included practice facilitation into their intervention reported significant effects in one or more primary outcomes. Conclusions: Our results demonstrate that practice facilitation with regular, tailored follow up is a powerful component of a successful organizational change strategy. Academic detailing alone or combined with audit and feedback alone is ineffective without intensive follow up. Provision of educational materials and use of audit and feedback are often integral components of multifaceted implementation strategies. However, we didn\u27t find examples where those relatively limited strategies were effective as standalone interventions. System-level support through technology (such as automated reminders or alerts) is potentially helpful, but must be carefully tailored to clinic needs

Mobile Delivery of Treatment for Alcohol Use Disorders: A Review of the Literature

Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based systems engage the user using video games. Although many commercial applications for treatment of AUDs exist, few (if any) have empirical evidence of effectiveness. The available evidence suggests that although texting-based applications may have beneficial effects, they are probably insufficient as interventions for AUDs. Comprehensive recovery management systems have the strongest theoretical base and have yielded the strongest and longest-lasting effects, but challenges remain, including cost, understanding which features account for effects, and keeping up with technological advances