A multimodal network design problem for domestic container transportation with short sea shipping

With the growing importance of logistic in a green and environmental friendly way, it is widely accepted that short sea shipping (SSS) is a mean to divert the freight traffic from congested corridor in local communities as well as to reduce environmental costs. It can also relieve the problem of traffic congestion and investment on road construction and maintenance. This paper considers a multimodal transportation model for domestic container cargos, in which the flow of container cargos moving between foreign seaports and domestic cities can be transported via domestic seaports using SSS and inland by truck. We propose a two-level strategy in evaluating the various government policies to encourage or regulate the usage of SSS. While the objective of the freight carriers is to minimize its transportation cost, the government could internalize the external cost and invest on the transportation network with considering the cost to the society. A case study with the Taiwan network is performed to illustrate the benefit and performance of the model.postprintThe 12th World Conference on Transport Research (WCTR), Lisbon, Portugal, 11-15 July 2010

Evaluation of InGaN/GaN light-emitting diodes of circular geometry

Blue GaN light emitting diodes (LEDs) in the shape of cuboids and circular disks have been fabricated by laser micromachining. The proposed circular geometry serves to enhance overall light extraction on a macro-scale and to improve uniformity of the emission pattern due to the rotational symmetry of the chip. Analysis of the chip shaping effect is carried out by ray-tracing simulations and further supported with mathematical modeling using ideal LED models, and subsequently verified with fabricated devices. In comparison, a 10% improvement in overall emission was observed for circular LEDs over the regular cuboids, consistent with simulations and calculations. The measured emission pattern from the circular LED confirms the axial symmetry of the emission beam. © 2009 Optical Society of America.published_or_final_versio

Enucleation of painful blind eye for refractory intraocular lymphoma after dose-limiting chemotherapy and radiotherapy

published_or_final_versionSpringer Open Choice, 25 May 201

Neuroimaging techniques in epilepsy

Objective: To review state-of-the-art neuroimaging modalities in epilepsy and their clinical applications. Data sources and study selection: PubMed literature searches to March 2010, using the following key words: 'epilepsy', 'positron emission tomography (PET)', 'single photon emission computed tomography (SPECT)', 'MR volumetry', 'diffusion tensor imaging', and 'functional MR imaging'. Data extraction All articles including neuroimaging techniques in epilepsy were included in the review. Data synthesis High-field magnetic resonance imaging is fundamental for high-resolution structural imaging. Functional radionuclide imaging (positron emission tomography/single-photon emission computed tomography) can provide additional information to improve overall accuracy, and show good results with high concordance rates in temporal lobe epilepsy. Magnetic resonance spectroscopy is a useful adjunct consistently demonstrating changing metabolites in the epileptogenic region. Magnetic resonance volumetric imaging shows excellent sensitivity and specificity for temporal lobe epilepsy but thus far it has been inconsistent for extratemporal epilepsy. Diffusion tensor imaging with tractography allows visualisation of specific tracts such as connections with the language and visual cortex to enhance preoperative evaluation. Functional magnetic resonance imaging using blood oxygen level-dependent activation techniques is mainly used in presurgical planning for the high-sensitivity mapping of the eloquent cortex. Both contrast-bolus and arterial spin labelling magnetic resonance perfusion imaging show good correlation with clinical lateralisation of seizure disorder. Conclusion Structural imaging is essential in localisation and lateralization of the seizure focus. Functional radionuclide imaging or advanced magnetic resonance imaging techniques can provide complementary information when an epileptogenic substrate is not identified or in the presence of non-concordant clinical and structural findings.link_to_subscribed_fulltex

Geometrical shaping of InGaN light-emitting diodes by laser micromachining

Geometrical shaping of InGaN light-emitting diodes (LEDs) by laser micromachining is introduced. The sapphire substrate is shaped with inclined sidewalls at 50, serving as a prism favoring light redirection for out-coupling from the top window. Compared to conventional cuboid LEDs with a calculated light extraction efficiency next of 18.3%, these shaped LEDs offers a pronounced increase in next of up to 85.2%, verified by experimental results. © 2009 IEEE.published_or_final_versio

Psychometric assessment of the Chinese version of the Supportive Care Needs Survey short-form (SCNS-SF34-C) among Hong Kong and Taiwanese Chinese colorectal cancer patients

published_or_final_versio

On the Association Between Demographic Structural Change and the Effectiveness of Nurse Staffing Policy for Inpatient Care: Evidence from Taiwan

Yi-Ling Lai,1,2 Wen-Yi Chen,3,* Shiuan-Shinn Lee,1,* Yung-Po Liaw1,4,5 1Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 402367, Taiwan; 2Community Health Center, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, 427213, Taiwan; 3Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, 403301, Taiwan; 4Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, 402367, Taiwan; 5Institute of Medicine, Chung Shan Medical University, Taichung, 402367, Taiwan*These authors contributed equally to this workCorrespondence: Wen-Yi Chen, Department of Senior Citizen Service Management, National Taichung University of Science and Technology, 193 Sec 1, San-Min Road, Taichung, 403301, Taiwan, Tel +886 4 22196932, Email [email protected] Shiuan-Shinn Lee, Department of Public Health, Chung Shan Medical University, 110, Section 1, Jianguo North Road, Taichung, 402367, Taiwan, Tel +886 4 24730022 Ext 12185, Email [email protected]: This study investigates the influence of demographic changes on the effectiveness of hospital nurse staffing policy, measured by the cumulative response of inpatient care quality to adjustments in hospital nurse staffing levels in Taiwan.Methods: The research design utilized in this study aligns with the observational time-series methodology, and a total of 99 monthly time-series observations were collected from multiple databases administered by the Taiwan government over the period from January 2015 to March 2023. Specifically, the time-varying parameter vector autoregressive and autoregressive distributed lag models were employed to investigate the association between age distribution and nurse staffing policy effectiveness.Results: The time-varying impulse responses of the unplanned 14-day readmission rate after discharge to changes in nurse staffing levels indicate a positive association between patient-to-nurse ratios and unplanned 14-day readmission rates across various types of hospitals. Nevertheless, the effectiveness of hospitals’ nurse staffing policy is observed to diminish with population aging, particularly evident in medical centers and regional hospitals.Conclusion: Policymakers should establish lower mandated patient-to-nurse ratios, grounded in practical nurse workforce planning, to address the needs of an aging society and enhance inpatient care quality through improved nurse staffing in hospitals.Keywords: demographic structural change, nurse staffing, inpatient care quality, time-varying parameter vector autoregressive model, autoregressive distributed lags mode

Attributing variance in supportive care needs during cancer: Culture-service, and individual differences, before clinical factors

Background Studies using the Supportive Care Needs Survey (SCNS) report high levels of unmet supportive care needs (SCNs) in psychological and less-so physical & daily living domains, interpreted as reflecting disease/treatment-coping deficits. However, service and culture differences may account for unmet SCNs variability. We explored if service and culture differences better account for observed SCNs patterns. Methods Hong Kong (n = 180), Taiwanese (n = 263) and Japanese (n = 109) CRC patients’ top 10 ranked SCNS-34 items were contrasted. Mean SCNS-34 domain scores were compared by sample and treatment status, then adjusted for sample composition, disease stage and treatment status using multivariate hierarchical regression. Results All samples were assessed at comparable time-points. SCNs were most prevalent among Japanese and least among Taiwanese patients. Japanese patients emphasized Psychological (domain mean = 40.73) and Health systems and information (HSI) (38.61) SCN domains, whereas Taiwanese and Hong Kong patients emphasized HSI (27.41; 32.92) and Patient care & support (PCS) (19.70; 18.38) SCN domains. Mean Psychological domain scores differed: Hong Kong = 9.72, Taiwan = 17.84 and Japan = 40.73 (p<0.03–0.001, Bonferroni). Other SCN domains differed only between Chinese and Japanese samples (all p<0.001). Treatment status differentiated Taiwanese more starkly than Hong Kong patients. After adjustment, sample origin accounted for most variance in SCN domain scores (p<0.001), followed by age (p = 0.01–0.001) and employment status (p = 0.01–0.001). Treatment status and Disease stage, though retained, accounted for least variance. Overall accounted variance remained low. Conclusions Health service and/or cultural influences, age and occupation differences, and less so clinical factors, differentially account for significant variation in published studies of SCNs.published_or_final_versio