The Optimal Inventory Policy with the Reusable Raw Material and Imperfect Items

This paper covers four topics regarding inventory models, namely reusable raw material, the EPQ model, imperfect-quality items, and the present value method. The relevant cost value used in traditional EPQ models does not include the stockholding cost of raw material, which makes such models unsuitable for investigating production. Because people in the world are attempting to reduce the impact of environmental impairment and increasing market competition, all products are manufactured from 100% reusable raw material and are screened during the manufacturing process. By taking the fixed proportion of imperfect-quality items and the time value into account and applying the present value method to analyze optimal inventory policies, this study creates a modified EPQ inventory model that is close to real life we meet. Furthermore, this model aims to promote the reputation of a company and ascertain its costs accurately

Factors Predicting Emotional Cue-Responding Behaviors of Nurses in Taiwan: An Observational Study

Objective Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer. Methods This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE. Results A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE. Conclusions This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication

School Organizational Innovative Indicators For Technical Universities And Institutes

This study aimed to construct the organizational innovation indicators of technical universities and institutes. This study held a group discussion and expert focus meeting and afterward, this study generalized seven facets of school organizational innovation: leadership innovation, administration innovation, student guidance and activity innovation, curriculum and instruction innovation, teacher professional development innovation, resource application innovation, and campus construction innovation. Then 25 criteria and 83 indices were developed

Carbon Dioxide Angiography in Lower Limbs: A Prospective Comparative Study With Selective Iodinated Contrast Angiography

This was a prospective comparison of the accuracy and image quality of carbon dioxide digital subtraction angiography (CO2 DSA) and iodinated contrast digital subtraction angiography (ICDSA) in evaluating lower extremity arteries and patient tolerance of the procedures. Selective DSA was performed in 14 Taiwanese patients who were diagnosed with peripheral artery occlusive disease (PAOD). Both contrast materials were administered through mechanical injectors. Post-processing of the image used pixel shifting. Images of vessels were divided into 22 anatomic segments and evaluated by two experienced radiologists. A four-point scale was used to classify diseased vessels. Two interpreters rated the CO2 DSA image against the ICDSA image on a three-point scale. Patient tolerance was assessed from verbal descriptions. Cohen's kappa was used to determine interobserver agreement and descriptive statistics were used to summarize patient experience. Interobserver agreement ranged from fair to excellent, with most being good or excellent. Three patients (21.4%) could not tolerate the whole procedure and nine patients (64.3%) reported discomfort during the CO2 DSA procedure. CO2 DSA image quality was better for the thigh than the distal runoff and pelvic regions. Our results showed that selective CO2 DSA cannot replace ICDSA as a routine diagnostic tool for PAOD because it does not give images of comparative quality

Multidetector CT Findings of a Congenital Coronary Sinus Anomaly: a Report of Two Cases

Congenital coronary sinus anomalies are extremely rare, and they have received relatively little attention. This is probably due to the lack of both clinical symptoms and significant cardiac functional disturbance. We present two cases of a coronary sinus anomaly and briefly review the literature. Recognizing and being familiar with the variations of a congenital coronary sinus anomaly in congenital heart disease may avoid a misinterpretation of cardiac catheterization findings and the troublesome disruption of coronary sinus blood return during the surgical management of cardiac lesions

Longitudinal Changes in Retinal Nerve Fiber Layer Thickness after Acute Primary Angle Closure Measured with Optical Coherence Tomography

PURPOSE. Longitudinal follow-up of peripapillary retinal nerve fiber layer (RNFL) thickness after an episode of acute primary angle closure (APAC) using Stratus optical coherence tomography (OCT). METHODS. Seventeen patients who had experienced a single unilateral APAC episode (intraocular pressure, Ͼ50 mm Hg) were enrolled. The average and superior, temporal, inferior, and nasal quadrant RNFL thicknesses of the affected and fellow eyes at 1, 4, and 12 weeks after remission were compared by using StratusOCT. The relationship between average RNFL thickness and interval of follow-up were evaluated with regression analysis. RESULTS. The mean duration of the APAC episode was 13.8 hours (range, 3-40). Comparison of the average and four quadrant RNFL thicknesses in the affected eyes longitudinally showed significant differences between 1 and 4, and 1 and 12 weeks, but not between 4 and 12 weeks. The average and four-quadrant RNFL thicknesses for the affected eyes were greater than the analogous values for fellow eyes at 1 week. In contrast, the inferior-and superior-quadrant RNFL thicknesses for the affected eyes were lower at 4 and 12 weeks, whereas the average and nasal quadrant values for the affected eyes were lower than those in fellow eyes at 12 weeks. Average RNFL thickness for the affected eyes was correlated with the interval of follow-up by using inverse regression analysis (P Ͻ 0.001; R 2 ϭ 0.60). Controlling for duration of APAC episode, the interval of follow-up on RNFL thickness reduction remained significant (P Ͻ 0.001, r ϭ Ϫ0.69). CONCLUSIONS. This study demonstrated an initial increase in diffuse RNFL thickness after a single APAC episode, followed by a subsequent decrease. (Invest Ophthalmol Vis Sci. 2007; 48:1659 -1664) DOI:10.1167/iovs.06-0950 A cute primary angle closure (APAC) is an ophthalmic emergency and a potentially blinding disease. Optic nerve damage can occur after the sudden rise in intraocular pressure (IOP) associated with an APAC episode. The optic disc appears edematous during this episode, and pallor with or without cupping may develop after remission. When treatment is delayed, vision may be markedly reduced to hand movement or light perception. 1 Perimetric examination during acute episodes is difficult and usually unreliable. After remission, visual field defects vary greatly in severity and type. 2 Measurement of retinal nerve fiber layer (RNFL) thickness loss after APAC is very important, as it is both objective and sensitive in terms of detection of the optic disc damage with either normal or unreliable visual fields. Scanning laser polarimetry with fixed corneal compensator (SLP-FCC) has been used for quantification of RNFL thickness change after APAC in cross-sectional study, 5 However, the latter investigation included several patients with poor IOP control after an APAC episode, as determined by RNFL measurement at follow-up. Moreover, SLP-FCC has limited functionality in measurement of RNFL thickness because of the lack of correction for variation in corneal polarization axis and corneal curvature. StratusOCT is a powerful imaging technology that can measure RNFL thickness and image tissue structure to an axial resolution of Ͻ10 m. 7 The stronger association with function in StratusOCT RNFL measurement compared with SLP-VCC suggests that the former may be superior for evaluation of glaucoma progression. 8 Therefore, the purpose of this study was to use StratusOCT to detect longitudinal change (1-12 weeks) in RNFL thickness after remission from a single APAC episode. MATERIALS AND METHODS In this prospective study, longitudinal observations were made using RNFL measurements obtained from StratusOCT at 1, 4, and 12 weeks after a single episode of unilateral APAC. Seventeen consecutive patients were recruited while undergoing treatment in the emergency or the ophthalmology outpatient departments of the Chang Gung Memorial Hospital-Kaohsiung Medical Center over a 1-year period. The study and data accumulation were in conformity with all relevant Taiwanese laws, and the investigation was conducted in accordance with the tenets of the Declaration of Helsinki. The APAC definition used for the study consisted of: The inclusion criteria were: (1) duration of episode less than 48 hours (interval from onset of acute symptoms to first hospital presentation); (2) resolution of acute episode and IOP control (Ͻ21 mm Hg) after antiglaucoma medication prescribed on first presentation, with interval between presentation and resolution under 2 hours (patients were treated with intravenous mannitol drip, oral acetazolamide, topical ␤-blocker and pilocarpine; the IOP was then rechecked 30 to 60 minutes after treatment); (3) subsequent laser iridotomy (LI) performed within 2 days of presentation on both affected and fellow eyes; and, (4) IOP Ͻ 21 mm Hg in both eyes for up to 12 weeks after treatment. Antiglaucoma medication was used to control IOP before and after LI in both eyes to prevent elevation (IOP Ͼ 21 mm Hg). The exclusion criteria were: (1) history of previous APAC in the affected or fellow eyes; (2) previous intraocular surgery, coexisting From th

Comparative global immune-related gene profiling of somatic cells, human pluripotent stem cells and their derivatives: implication for human lymphocyte proliferation.

Human pluripotent stem cells (hPSCs), including embryonic stem cells (ESCs) and induced PSCs (iPSCs), represent potentially unlimited cell sources for clinical applications. Previous studies have suggested that hPSCs may benefit from immune privilege and limited immunogenicity, as reflected by the reduced expression of major histocompatibility complex class-related molecules. Here we investigated the global immune-related gene expression profiles of human ESCs, hiPSCs and somatic cells and identified candidate immune-related genes that may alter their immunogenicity. The expression levels of global immune-related genes were determined by comparing undifferentiated and differentiated stem cells and three types of human somatic cells: dermal papilla cells, ovarian granulosa cells and foreskin fibroblast cells. We identified the differentially expressed genes CD24, GATA3, PROM1, THBS2, LY96, IFIT3, CXCR4, IL1R1, FGFR3, IDO1 and KDR, which overlapped with selected immune-related gene lists. In further analyses, mammalian target of rapamycin complex (mTOR) signaling was investigated in the differentiated stem cells following treatment with rapamycin and lentiviral transduction with specific short-hairpin RNAs. We found that the inhibition of mTOR signal pathways significantly downregulated the immunogenicity of differentiated stem cells. We also tested the immune responses induced in differentiated stem cells by mixed lymphocyte reactions. We found that CD24- and GATA3-deficient differentiated stem cells including neural lineage cells had limited abilities to activate human lymphocytes. By analyzing the transcriptome signature of immune-related genes, we observed a tendency of the hPSCs to differentiate toward an immune cell phenotype. Taken together, these data identify candidate immune-related genes that might constitute valuable targets for clinical applications

Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of São Tomé and Príncipe, West Africa

Background: Although the Democratic Republic of Sao Tome and Principe (DRSTP) has undertaken school children-based deworming programs against intestinal parasitic infections (IPIs) using a single dose of mebendazole annually since 2005, it remains unclear as to the outcome to date. The present study intends to  investigate the recent IPIs status among school children living in capital areas of the DRSTP.Methods: A total of 252 school children (121 boys and 131 girls) of grades 4 and 5 from 4 primary schools located in the capital areas participated in the present study and their fresh fecal specimens were examined for the presence of any parasites using the merthiolate- iodine-formaldehyde concentration method as conducted.Results: The overall prevalence of IPIs was 64.7% (163/ 252). No significant gender difference in prevalence between boys (67.8%) and girls (61.8%) was found (p = 0.3). The majority of school children were infected with a single species of parasite (55.8%). Altogether, 12 different intestinal parasite species were identified in DRSTP school children, of which 9 species were pathogenic and the remaining 3 were non-pathogenic.Conclusion: Improving the detection method, sanitation facilities and personal hygiene as well as utilizing combined drugs are all important measures to greatly reduce IPIs in DRSTP school children.Keywords: Democratic Republic of Sao Tome and Principe, school children, intestinal parasitic infection