Comparison of extracorporeal shock wave lithotripsy running models between outsourcing cooperation and rental cooperation conducted in Taiwan

Background/PurposeWe conducted a retrospective study to compare the cost and effectiveness between two different running models for extracorporeal shock wave lithotripsy (SWL), including the outsourcing cooperation model (OC) and the rental cooperation model (RC).MethodsBetween January 1999 and December 2005, we implemented OC for the SWL, and from January 2006 to October 2011, RC was utilized. With OC, the cooperative company provided a machine and shared a variable payment with the hospital, according to treatment sessions. With RC, the cooperative company provided a machine and received a fixed rent from the hospital. We calculated the cost of each treatment session, and evaluated the break-even point to estimate the lowest number of treatment sessions to make the balance between revenue and cost every month. Effectiveness parameters, including the stone-free rate, the retreatment rate, the rate of additional procedures and complications, were evaluated.ResultsCompared with OC there were significantly less treatment sessions for RC every month (42.6±7.8 vs. 36.8±6.5, p=0.01). The cost of each treatment session was significantly higher for OC than for RC (751.6±20.0 USD vs. 684.7±16.7 USD, p=0.01). The break-even point for the hospital was 27.5 treatment sessions/month for OC, when the hospital obtained 40% of the payment, and it could be reduced if the hospital got a greater percentage. The break-even point for the hospital was 27.3 treatment sessions/month for RC. No significant differences were noticed for the stone-free rate, the retreatment rate, the rate of additional procedures and complications.ConclusionOur study revealed that RC had a lower cost for every treatment session, and fewer treatment sessions of SWL/month than OC. The study might provide a managerial implication for healthcare organization managers, when they face a situation of high price equipment investment

Patient-oriented simulation based on Monte Carlo algorithm by using MRI data

<p>Abstract</p> <p>Background</p> <p>Although Monte Carlo simulations of light propagation in full segmented three-dimensional MRI based anatomical models of the human head have been reported in many articles. To our knowledge, there is no patient-oriented simulation for individualized calibration with NIRS measurement. Thus, we offer an approach for brain modeling based on image segmentation process with <it>in vivo </it>MRI T1 three-dimensional image to investigate the individualized calibration for NIRS measurement with Monte Carlo simulation.</p> <p>Methods</p> <p>In this study, an individualized brain is modeled based on <it>in vivo </it>MRI 3D image as five layers structure. The behavior of photon migration was studied for this individualized brain detections based on three-dimensional time-resolved Monte Carlo algorithm. During the Monte Carlo iteration, all photon paths were traced with various source-detector separations for characterization of brain structure to provide helpful information for individualized design of NIRS system.</p> <p>Results</p> <p>Our results indicate that the patient-oriented simulation can provide significant characteristics on the optimal choice of source-detector separation within 3.3 cm of individualized design in this case. Significant distortions were observed around the cerebral cortex folding. The spatial sensitivity profile penetrated deeper to the brain in the case of expanded CSF. This finding suggests that the optical method may provide not only functional signal from brain activation but also structural information of brain atrophy with the expanded CSF layer. The proposed modeling method also provides multi-wavelength for NIRS simulation to approach the practical NIRS measurement.</p> <p>Conclusions</p> <p>In this study, the three-dimensional time-resolved brain modeling method approaches the realistic human brain that provides useful information for NIRS systematic design and calibration for individualized case with prior MRI data.</p

Paleozoic tectonics of the southern Chinese Tianshan: Insights from structural, chronological and geochemical studies of the Heiyingshan ophiolitic mélange (NW China)

International audienceIn the southern Chinese Tianshan, the southernmost part of the Central Asian Orogenic Belt (CAOB), widespread ophiolitic mélanges form distinct tectonic units that are crucial for understanding the formation of the CAOB. However, the timing of tectonic events and subduction polarity are still in controversy. In order to better understand these geological problems, a comprehensive study was conducted on the Heiyingshan ophiolitic mélange in the SW Chinese Tianshan. Detailed structural analysis reveals that the ophiolitic mélange is tectonically underlain by sheared and weakly metamorphosed pre-Middle Devonian rocks, and unconformably overlain by non-metamorphic and undeformed lower Carboniferous (Serpukhovian) to Permian strata. The igneous assemblage of the mélange comprises OIB-like alkali basalt and andesite, N-MORB-like tholeiitic basalt, sheeted diabase dikes, cumulate gabbro and peridotite. Mafic rocks display supra-subduction signatures, and some bear evidence of contamination with the continental crust, suggesting a continental marginal (back-arc) basin setting. Zircons of a gabbro were dated at 392 ± 5 Ma by the U-Pb LA-ICP-MS method. Famennian-Visean radiolarian microfossils were found in the siliceous matrix of the ophiolitic mélange. Mylonitic phyllite which displays northward-directed kinematic evidence yielded muscovite 40Ar/39Ar plateau ages of 359 ± 2 Ma and 356 ± 2 Ma. These new data, combined with previously published results, suggest that the mafic protoliths originally formed in a back-arc basin in the Chinese southern Tianshan during the late Silurian to Middle Devonian and were subsequently incorporated into the ophiolitic mélange and thrust northward during the Late Devonian to early Carboniferous. Opening of the back-arc basin was probably induced by south-dipping subduction of the Paleo-Tianshan Ocean in the early Paleozoic, and the Central Tianshan block was rifted away from the Tarim block. Closure of the back-arc basin in the early Carboniferous formed the South Tianshan Suture Zone and re-amalgamated the two blocks

The squeeze film effect on micro-electromechanical resonators

The air squeeze film damping effect on the dynamic responses of clamped micro- electromechanical resonators is investigated in this study. A dynamic model for a clamped micro-electromechanical resonator with the damping consideration is derived using Lagrange’s equation. The corresponding resonator eigen solutions are formulated and solved by employing the assumed-mode method. The effect of different parameters; i.e. the resonator size, ambient temperature and pressure on the squeeze film damping characteristics were simulated and investigated. The results indicate that the squeeze film damping effect may significantly affect the dynamic responses of micro-scale electromechanical resonator

Genomics and proteomics of immune modulatory effects of a butanol fraction of echinacea purpurea in human dendritic cells

<p>Abstract</p> <p>Background</p> <p><it>Echinacea </it>spp. extracts and the derived phytocompounds have been shown to induce specific immune cell activities and are popularly used as food supplements or nutraceuticals for immuno-modulatory functions. Dendritic cells (DCs), the most potent antigen presenting cells, play an important role in both innate and adaptive immunities. In this study, we investigated the specific and differential gene expression in human immature DCs (iDCs) in response to treatment with a butanol fraction containing defined bioactive phytocompounds extracted from stems and leaves of <it>Echinacea purpurea</it>, that we denoted [BF/S+L/Ep].</p> <p>Results</p> <p>Affymetrix DNA microarray results showed significant up regulation of specific genes for cytokines (IL-8, IL-1β, and IL-18) and chemokines (CXCL 2, CCL 5, and CCL 2) within 4 h after [BF/S+L/Ep] treatment of iDCs. Bioinformatics analysis of genes expressed in [BF/S+L/Ep]-treated DCs revealed a key-signaling network involving a number of immune-modulatory molecules leading to the activation of a downstream molecule, adenylate cyclase 8. Proteomic analysis showed increased expression of antioxidant and cytoskeletal proteins after treatment with [BF/S+L/Ep] and cichoric acid.</p> <p>Conclusion</p> <p>This study provides information on candidate target molecules and molecular signaling mechanisms for future systematic research into the immune-modulatory activities of an important traditional medicinal herb and its derived phytocompounds.</p

Carbon nanotube composites for glucose biosensor incorporated with reverse iontophoresis function for noninvasive glucose monitoring

This study aims to develop an amperometric glucose biosensor, based on carbon nanotubes material for reverse iontophoresis, fabricated by immobilizing a mixture of glucose oxidase (GOD) and multiwalled carbon nanotubes (MWCNT) epoxy-composite, on a planar screen-printed carbon electrode. MWCNT was employed to ensure proper incorporation into the epoxy mixture and faster electron transfer between the GOD and the transducer. Results showed this biosensor possesses a low detection potential (+500 mV), good sensitivity (4 μA/mM) and an excellent linear response range (r2 = 0.999; 0–4 mM) of glucose detection at +500 mV (versus Ag/AgCl). The response time of the biosensor was about 25 s. In addition, the biosensor could be used in conjunction with reverse iontophoresis technique. In an actual evaluation model, an excellent linear relationship (r2 = 0.986) was found between the glucose concentration of the actual model and the biosensor’s current response. Thus, a glucose biosensor based on carbon nanotube composites and incorporated with reverse iontophoresis function was developed

Mitochondrial oxidative phosphorylation complex regulates NLRP3 inflammasome activation and predicts patient survival in nasopharyngeal carcinoma

© 2020 Chung et al. We previously reported that tumor inflammasomes play a key role in tumor control and act as favorable prognostic markers in nasopharyngeal carcinoma (NPC). Activated inflammasomes frequently form distinguishable specks and govern the cellular secretion of IL-1β. However, we know little about the biological and biochemical differences between cells with and without apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC) speck formation. In this study, we used proteomic iTRAQ analysis to analyze the proteomes of NPC cells that differ in their ASC speck formation upon cisplatin treatment. We identified proteins that were differentially over-expressed in cells with specks, and found that they fell into two Gene ontology (GO) pathways: mitochondrial oxidative phosphorylation (OxPhos) and ubiquinone metabolism. We observed up-regulation of various components of the OxPhos machinery (including NDUFB3, NDUFB8 and ATP5B), and subsequently found that these changes lead to mitochondrial ROS (mtROS) production, which promotes the formation and activation of NLRP3 inflammasomes and subsequent pyroptosis. In NPC patients, better local recurrence-free survival was significantly associated with high-level expression of NDUFB8 (p = 0.037) and ATP5B (p = 0.029), as examined using immunohistochemistry. However, there were no significant associations between the expression of NDUFB8 and ATP5B with overall survival of NPC patients. Together, our results demonstrate that up-regulated mitochondrial OxPhos components are strongly associated with NLRP3 inflammasome activation in NPC. Our findings further suggest that high-level expression of OxPhos components could be markers for local recurrence and/or promising therapeutic targets in patients with NPC