Problems of Online Physician-Patient Communication: An Investigation of a WebHospital in Taiwan

This study investigates patterns of on-line communication between physicians and patients on the consulting board of the KingNet WebHospital in Taiwan. The dermatology, urology, gynecology and pediatrics departments, which all have frequent physician-patient interaction on KingNet, were selected as samples. After conducting content analysis of total 600 on-line messages between physicians and patients from these four departments, we classified patients’ questions into four categories: “Symptoms and Diseases,” “Medications or Treatments,” “Tests or Diagnostic Procedures,” and “Prevention.” We also analyzed physicians’ responses and classified them into three types: ignore, partially-fulfil and fulfil. While questions involving “Symptoms and Diseases” were the ones most commonly raised by patients in all four departments, they were also the ones that most physicians ignored or answered only vaguely. To understand the possible causes of this gap, interviews were conducted with the physicians. The results show that, for physicians it is difficult to answer such questions on-line due to uncertainty of medical treatments, restrictions imposed by medical regulations, the possibility of medical disputes, and the perception gap between patients and physicians. Consequently, physicians tend to either offer “partial” suggestions or ask patients to go to hospital for further examination

ICT for Development: Two Contradictory Stories of an ICT Initiative

In this study we explore two different perspectives of one ICT project. The “mainstream” believed that an educational ICT project for Taiwanese aboriginals was successful, while the local aboriginals and local teachers did not. Using ethnographic research, we investigated the possible reasons for the disparity between the views of the mainstream and the locals. Our findings indicate that the paternalistic nature of the ICT project as well as a belief in technological supremacy contributed to the discrepancy of views regarding the success of the project. We use postcolonial theory to draw attention to the (often forgotten) voice of the aboriginals

ERP Post-Implementation Learning, ERP Usage And Individual Performance Impact

In recent years, an increasing number of companies that have implemented ERP systems have expressed disappointment over a failure to reach anticipated goals. A major reason for this failure is the inefficient use of the ERP system by employees. Therefore, the critical issue is how users can most effectively take advantage of an ERP system. Post-implementation learning plays an important role in facilitating ERP usage and thus promotes individual performance. Particularly, the integrated and sophistic natures of ERP systems force users to learn continuously after ERP implementation. This study employed a survey method to examine the perceptions of a dataset of 659 ERP users. We found that ERP usage facilitates individual performance, including individual productivity, customer satisfaction and management control, and post-implementation learning contributes to all three types of ERP usage, including decision support, work integration and customer service. Our findings can provide academics and practitioners with knowledge of how to improve ERP usage and ensure individual performance impacts

Can environmental DNA be used to detect first arrivals of the cane toad, Rhinella marina, into novel locations?

Eradicating invasive species is difficult, but success is more likely when populations are small after arrival. The cane toad, Rhinella marina, is an invasive pest species that threatens native fauna worldwide. Increasingly, environmental DNA (eDNA) is used as a technique to monitor the presence of invasive species given its power to detect low numbers of individuals. We aimed to investigate eDNA persistence in freshwater at three different temperatures (25, 30 and 35°C) and eDNA detection thresholds for R. marina using controlled experiments in aquaria. For the latter, two water volumes and two cane toad exposure times were used (800 or 200 L volume with 5 or 30 min exposure). A 15‐ml water sample was collected from each replicated aquaria and preserved with 5 ml Longmire's buffer. Environmental DNA was extracted and four technical quantitative PCR replicates were analyzed targeting the cane toad 16S rDNA mitochondrial gene. Environmental DNA decayed rapidly in water and was reliably detected for up to 3 days after cane toad removal, regardless of the temperature treatment. Also, cane toad eDNA was detected in the water after a 5‐min initial exposure of a single individual in 800 L of water. Under the physical parameters tested here, a positive detection means that a cane toad has been in contact with the water body between 1 and 3 days prior to the sampling event. The results of the present study show the importance of eDNA for determining the presence of a species that occurs at low abundance in a small water body, such as at the onset of a cane toad invasion

Nestin depletion induces melanoma matrix metalloproteinases and invasion

Matrix metalloproteinases (MMPs) are key biological mediators of processes as diverse as wound healing, embryogenesis, and cancer progression. Although MMPs may be induced through multiple signaling pathways, the precise mechanisms for their regulation in cancer are incompletely understood. Because cytoskeletal changes are known to accompany MMP expression, we sought to examine the potential role of the poorly understood cytoskeletal protein, nestin, in modulating melanoma MMPs. Nestin knockdown (KD) upregulated expression of specific MMPs and MMP-dependent invasion both through extracellular matrix barriers in vitro and in peritumoral connective tissue of xenografts in vivo. Development of 3-dimensionsal melanospheres that in vitro partially recapitulate non-invasive tumorigenic melanoma growth was inhibited by nestin KD, although ECM invasion by aberrant melanospheres that did form was enhanced. Mechanistically, nestin KD-dependent melanoma invasion was associated with intracellular redistribution of phosphorylated focal adhesion kinase (pFAK) and increased melanoma cell responsiveness to transforming growth factor-beta (TGF-β), both implicated in pathways of melanoma invasion. The results suggest that the heretofore poorly understood intermediate filament, nestin, may serve as a novel mediator of MMPs critical to melanoma virulence

Radiation hardness qualification of PbWO4 scintillation crystals for the CMS Electromagnetic Calorimeter

This is the Pre-print version of the Article. The official published version can be accessed from the link below - Copyright @ 2010 IOPEnsuring the radiation hardness of PbWO4 crystals was one of the main priorities during the construction of the electromagnetic calorimeter of the CMS experiment at CERN. The production on an industrial scale of radiation hard crystals and their certification over a period of several years represented a difficult challenge both for CMS and for the crystal suppliers. The present article reviews the related scientific and technological problems encountered

Large-scale genome-wide association studies and meta-analyses of longitudinal change in adult lung function.

BACKGROUND: Genome-wide association studies (GWAS) have identified numerous loci influencing cross-sectional lung function, but less is known about genes influencing longitudinal change in lung function. METHODS: We performed GWAS of the rate of change in forced expiratory volume in the first second (FEV1) in 14 longitudinal, population-based cohort studies comprising 27,249 adults of European ancestry using linear mixed effects model and combined cohort-specific results using fixed effect meta-analysis to identify novel genetic loci associated with longitudinal change in lung function. Gene expression analyses were subsequently performed for identified genetic loci. As a secondary aim, we estimated the mean rate of decline in FEV1 by smoking pattern, irrespective of genotypes, across these 14 studies using meta-analysis. RESULTS: The overall meta-analysis produced suggestive evidence for association at the novel IL16/STARD5/TMC3 locus on chromosome 15 (P  =  5.71 × 10(-7)). In addition, meta-analysis using the five cohorts with ≥3 FEV1 measurements per participant identified the novel ME3 locus on chromosome 11 (P  =  2.18 × 10(-8)) at genome-wide significance. Neither locus was associated with FEV1 decline in two additional cohort studies. We confirmed gene expression of IL16, STARD5, and ME3 in multiple lung tissues. Publicly available microarray data confirmed differential expression of all three genes in lung samples from COPD patients compared with controls. Irrespective of genotypes, the combined estimate for FEV1 decline was 26.9, 29.2 and 35.7 mL/year in never, former, and persistent smokers, respectively. CONCLUSIONS: In this large-scale GWAS, we identified two novel genetic loci in association with the rate of change in FEV1 that harbor candidate genes with biologically plausible functional links to lung function

Double Field Theory for Double D-branes

We consider Hull's doubled formalism for open strings on D-branes in flat space and construct the corresponding effective double field theory. We show that the worldsheet boundary conditions of the doubled formalism describe in a unified way a T-dual pair of D-branes, which we call double D-branes. We evaluate the one-loop beta function for the boundary gauge coupling and then obtain the effective field theory for the double D-branes. The effective field theory is described by a DBI action of double fields. The T-duality covariant form of this DBI action is thus a kind of "master" action, which describes all the double D-brane configurations related by T-duality transformations. We discuss a number of aspects of this effective theory.Comment: Latex, 1+33 pages. v2 with minor corrections, a new reference added. v3 a typo correcte