Evaluating the Operational Efficiency of Life Insurance Companies in Taiwan– An Application of the Dynamic Network SBM Model

Using a Dynamic Network Slack-based Measurement model (Tone & Tsutsui, 2014), this study evaluated the operational efficiency of life insurance firms in Taiwan from 2006 to 2013. In contrast to previous research, we incorporated assets and liabilities management into the model and compared them against optimal efficiency values in order to determine whether firms are earning maximizing profit while ensuring long-term solvency. The life insurance industry in Taiwan has matured. We found that market competitiveness depends on firms size and business model. Financial holdings companies and large corporations are performing strongly, while small local firms and foreign-owned firms scored poorly in technical efficiency. Economies of scale contribute to the business performance of life insurance firms. Life insurance companies that had merged with or been acquired by financial holdings firms showed notable improvement in efficiency. However, change in term efficiency is a warning signal in long-term business performance of life insurance firms. Lastly, most companies achieved optimal carry-over efficiency, indicating that they place considerable emphasis on managing assets and liabilities in order to ensure future solvency

Animal Assisted Intervention for Rehabilitation Therapy and Psychotherapy

Animal-assisted Intervention (AAI) is a goal-oriented intervention that intentionally includes or incorporates animals in health, education, and human service for the purpose of therapeutic gains in humans. AAI incorporates human-animal teams in formal human service such as Animal-assisted Therapy (AAT) or Animal-assisted Education (AAE). Animal-assisted Activity (AAA) is the informal AAI often conducted on a volunteer basis by the human-animal team for motivational, educational, and recreational purposes. AAI could be used for rehabilitation therapy and psychotherapy for patients with various symptoms. AAI uses animals, mostly dogs, to aid in healing patients holistically. Dogs have an overwhelming gratitude and exuberance for life and this effect on people is astounding. Furthermore, AAI has been researched and its effectiveness on patients’ outcomes and healing is documented. With a soaring trend of the incorporation of complementary therapies into the mainstream of therapy and health care, animal-facilitated therapy has become a popular interest for the therapy team to integrate into a patient’s plan of therapy

Simultaneous rota-stenting and transcatheter aortic valve implantation for patients with heavily calcified coronary stenosis and aortic stenosis

AbstractGiven that coronary artery disease (CAD) in octogenarians undergoing transcatheter aortic valve implantation (TAVI) often presents with more complex lesions and extensive calcification, rotational atherectomy (RA) may be needed in some cases before stenting. However, data regarding the feasibility and safety of simultaneous RA during TAVI using the Medtronic CoreValve (MCV; Medtronic, Minneapolis, MN, USA) system are lacking. Three out of 107 (2.8%) patients (2 females, average age 85.6 years, mean aortic valve area 0.5 cm2, mean left ventricular ejection fraction 39%, mean Logistic EuroScore 70%), with complex, heavily calcified coronary stenosis, and severe valvular aortic stenosis (AS) were treated with TAVI and RA due to high surgical risk. After balloon valvuloplasty, all coronary lesions were successfully treated with RA and stenting, immediately followed by transfemoral TAVI with a self-expandable MCV. Our data suggested that in the very elderly patients with severe and heavily calcified CAD and AS who were turned down for cardiac surgery, RA and stenting followed by TAVI may be performed successfully in a combined, single-stage procedure

Heterogeneous amplification of ERBB2 in primary lesions is responsible for the discordant ERBB2 status of primary and metastatic lesions in gastric carcinoma

Aims: To determine the extent of HER2 homogeneity/heterogeneity in primary versus metastatic gastric carcinoma ( GC). Materials and results: The human epidermal growth factor receptor 2 ( HER2) status in primary and metastatic lesions was evaluated by immunohistochemistry ( IHC) and fluorescence in-situ hybridization ( FISH). Four separate cohorts consisting of primary GC alone or primary GC paired with metastatic lesions were examined. In the FISH analysis of 325 primary GCs, eight cases ( 2.5%) showed amplification with a heterogeneous pattern, whereas 27 cases ( 8.3%) showed amplification with a homogeneous pattern, and in this cohort the discordant: concordant FISH ratio based on examination of three different areas in each primary lesion was 0.30: 1. FISH testing using 250 paired primary and metastatic lesions revealed seven cases (2.8%) with discordant amplification. In metastatic disease positive conversion occurred in six cases (2.4%), whereas negative conversion happened in one case (0.4%). The discordant: concordant ratio of primary versus secondary lesions was 0.23: 1. When the seven discordant cases were re-evaluated using whole sections of primary GCs, six showed a heterogeneous pattern of amplification. Conclusions: These findings suggest that the discordant HER2 amplification observed in metastatic lesions is explained substantially by heterogeneity within primary tumours

Platelet-derived growth factor induces p21/WAF1 promoter in vascular smooth muscle cells via activation of an Sp1 site

AbstractMany studies suggested that cyclin-dependent kinase inhibitor (CDKI) p21 acts as a universal inhibitor of cyclin/CDK catalytic activity. This protein has also been shown to be a component of active cyclin/CDK complexes. In addition, it has recently been suggested that p21 serves as an assembly factor in platelet-derived growth factor (PDGF)-stimulated vascular smooth muscle cells (VSMC). However, little is known concerning the molecular mechanisms by which PDGF induces p21 gene expression in VSMC. In this report we demonstrate that PDGF induces the p21 expression at both the mRNA and protein levels. This increase in p21 gene expression was due to activation of the p21 promoter by PDGF. Through both deletion and mutation analysis of the p21 promoter, we defined a 10-bp sequence that is required for the activation of the p21 promoter by PDGF. In addition, gel shift and supershift assays demonstrated that this PDGF-responsive element binds specifically to the transcription factor Sp1. These results demonstrate that Sp1 mediates PDGF-induced p21 gene expression in VSMC. Moreover, immunoblot and immonoprecipitation analysis showed that the level of hyperphosphorylated retinoblastoma protein (Rb) is increased and the protein is physically associated with Sp1 in PDGF-treated cells, indicating that phosphorylated Rb may play a role in regulating Sp1 to activate p21 expression

A Systematic Review of Recreation Therapy for Depression in Older Adults

Background: Recreation therapy (RT) provides a flexible and powerful treatment for depression associated with aging. This article reviewed the effectiveness of RT to treat depression in older adults. Method: Five electronic databases were employed to identify interventional studies on RT in depressed older adults: Pubmed, PsycINFO, ProQuest, Academic Search Premier and ERIC. Articles were screened against inclusion criteria and assessed with respect to methodological quality. Results: A systematic literature review included 18 articles. Fourteen studies reported improvement in depression but 6 studies lack adequate significance in the positive effect of RT. Methodological quality assessment of 13 randomizedcontrolled trials and 5 non-controlled studies indicated an overall mean of 5.67 ± 1.94 points out of 9. Conclusion: There were positive findings that RT is effective in improving geriatric depression. Future investigation is encouraged to explore the mechanism between physical activity RT and depression improvement

Parental restriction reduces the harmful effects of in-bedroom electronic devices

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