Subject: Social Sciences, Law Keywords: value co-creation; National Health Insurance; My Health Bank; Service Ecosystem
Online: 22 January 2020 (02:55:28 CET)
Objective: Taiwan Government’s organizations have endeavored to promote the applications of big data and open data. The “My Health Bank” is one of the measures promoted by the National Health Administration, Ministry of Health and Welfare. This study proposes the perspective of the “value co-creation” with the attempt to extend the concept of service ecosystem and apply it on the platform of My Health Bank to examine whether people (patients, families, and caregivers) can promote their health literacy? Method: This cross-sectional study, with people that have registered at “My Health Bank” as subjects. Complying with the inclusion criteria, 401 questionnaires were delivered, with 391 valid ones, excluding those incompletely and inaccurately filled. Result: That the affecting factors of the co-creation of values: age, education level, annual income, and platform operation show to be significant ( p＜0.05); and gender, occupation, and resource exchange do not reach the significant level (p＞0.1). Conclusion: We found My Health Bank changed the inertia of “value creation” in the traditional medical value, it allows the traditional medical and healthcare industry to expose to the impacts of the mega trend of the internet, the transformation of the platform in a necessary trend.
Subject: Social Sciences, Behavior Sciences Keywords: hierarchical medical system, national health insurance, healthcare-seeking behavior, reduction in hospital visits
Online: 15 July 2019 (11:56:40 CEST)
Objective: This study investigated the effect of the hierarchical medical system under the national health insurance program on resident’s healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated the allowance reduction of outpatient visits at regional hospitals and higher hierarchical hospitals from 2018. The ultimate goal is to implement a hierarchical medical system and provide the residents accessible as well as consistent medical services. Methods: This research was conducted through the questionnaire survey method and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1,340 valid questionnaires were returned. Results: Regarding the effect on healthcare-seeking behavior, the following factors were significant: being aged between 40 to 49 (p＜.1), subjects with an educational background of junior high school (p＜.05), those who were not aware of the policy (p＜.001), and an awareness about both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p＜.001). Conclusion: The public should be made aware about the hierarchical medical system to improve healthcare.
ARTICLE | doi:10.20944/preprints202304.1051.v1
Subject: Physical Sciences, Mathematical Physics Keywords: eLoran; meteorological factor; propagation delay prediction model; Back-Propagation neural network
Online: 27 April 2023 (05:52:32 CEST)
The core of eLoran ground-based timing navigation system is the accurate measurement of groundwave propagation delay. However, meteorological changes will disturb the conductive characteristic factors along the groundwave propagation path, especially for complex terrestrial propagation environment, and may even lead to microsecond-level propagation delay fluctuation, seriously affecting the timing accuracy of the system. Aiming at this problem, this paper proposes a propagation delay prediction model based on Back-Propagation neural network (BPNN) for complex meteorological environment, which realizes the function of directly mapping propaga-tion delay fluctuation through meteorological factors. Firstly, the theoretical influence of meteoro-logical factors on each component of propagation delay is analyzed based on calculation parame-ters. Then, through the correlation analysis of the measured data, the complex relationship be-tween the seven main meteorological factors and the propagation delay, as well as their regional differences are demonstrated. Finally, a BPNN prediction model considering regional changes of multiple meteorological factors is proposed, and the validity of the model is verified by long-term collected data. Experimental results show that the proposed model can effectively predict the propagation delay fluctuation in the next few days, and its overall performance is significantly improved compared with the existing linear model and simple neural network model. eLoran; meteorological factor; propagation delay prediction model; Back-Propagation neural network;
ARTICLE | doi:10.20944/preprints201801.0134.v1
Subject: Medicine And Pharmacology, Pharmacology And Toxicology Keywords: Kalanchoe tubiflora; bufadienolide; CL1-5 human lung cancer cells; autophagy
Online: 16 January 2018 (06:38:11 CET)
Lung cancer is almost the most common cause of cancer death in the world. Clinically, the conventional therapy to eradicate the cancer cells is chemotherapy but a better drug remains required. In this study, the effects of three bufadienolides, kalantuboside B, kalantuboside A and bryotoxin C, isolated from Kalanchoe tubiflora (Harvey) were evaluated and characterized in CL1-5 highly metastatic human lung cancer cells. Contrary to the apoptosis-promoting activity in other cancer cells, these three bufadienolides did not induce apoptosis in CL1-5 cancer cells. Instead, they activated an autophagy pathway, as indicated by the increase of autophagosomes formation. The induction of autophagy by these three bufadienolides was demonstrated to link to down-regulation of p-mTOR as well as up-regulation of LC3-II, ATG5, ATG7, Beclin-1. Moreover, among these three compounds, kalantuboside B in which a monosaccharide is attached at the bufadienolide aglycon, exhibited a better autophagy induction. Our findings revealed an alternative mechanism of drug action by bufadienolides in lung cancer cells and provided evidence for the possibility of treating highly metastatic human lung cancer through an autophagy pathway.
ARTICLE | doi:10.20944/preprints202304.0515.v1
Subject: Medicine And Pharmacology, Medicine And Pharmacology Keywords: Flumazenil; LC-QqQ MS; Metabolism; r-aminobutyric acid receptor antagonist; benzodiazepine receptors
Online: 18 April 2023 (10:29:26 CEST)
Studies on the neurobiological causes of anxiety disorders suggest that the GABA system in-creases synaptic concentration and enhances the affinity of GABAA (type A) receptors for ben-zo-diazepine ligands. Flumazenil antagonizes the benzodiazepine binding site of the GABA (γ-aminobutyric acid) type /benzodiazepine receptor (BZR) complex in the central nervous sys-tem (CNS). The integration of the metabolites of flumazenil by LC-tandem mass spectrometry will complete understanding of the in vivo metabolism of flumazenil and accelerate radio-pharmaceutical inspection and registration. The main goal of our study was to investigate using reversed-phase HPLC (PR-HPLC) coupled with electrospray ionization triple quadrupole tan-dem mass spectrometry (ESI-QqQ MS) for the identification of flumazenil and its metabolites in a hepatic matrix. And a carrier-free nucleophilic fluorination with automatic synthesizer for [18F]flumazenil which applied to in vivo nano-positron emission tomography (Nano-PET)/computed tomography (CT) imaging and ex vivo bio-distribution used to analyze in normal rats. The study showed that 50% of the flumazenil was bio-transformed at 60 min by the rat liver homogenate, while one metabolite (M1) was a methyl transesterification product of flumazenil. In a rat liver microsomes system, two metabolites were identified (M2 and M3) as its carboxylic acid and hydroxylated ethylester forms, respectively. [18F]flumazenil in vivo nanoPET/CT imag-ing and ex vivo bio-distribution assay also showed significant effects on GABAA receptor availa-bility in the amygdala, prefrontal cortex, cortex, and hippocampus in the rat brain, worriless about the formation of metabolites. We showed completion of the bio-transformed course of flumazenil by the hepatic system; and [18F]flumazenil can be a good ligand and serve as a PET agent for determination of GABAA/BZR complex for multiplex neurological syndromes in the clinical stage.
ARTICLE | doi:10.20944/preprints201701.0117.v1
Subject: Biology And Life Sciences, Biochemistry And Molecular Biology Keywords: blunt snout bream; high carbohydrate; transcriptome; metabolomics; insulin resistance; fatty liver disease
Online: 26 January 2017 (03:52:10 CET)
A high intake of carbohydrates, associated with obesity, is one of the major causes of fatty liver disease in humans. This study investigated how high carbohydrate intake induces fatty liver disease in Blunt snout bream (Megalobrama amblycephala). Blunt snout bream were fed a high-carbohydrate diet (HCBD) for 60 days. Their growth indices were evaluated, and the transcriptomes, metabolites, biochemistry, and histology of their blood and livers were analyzed. The final weight, weight gain, specific growth rate, and feed conversion ratio were all higher in the HCBD group than in the control group, but not significantly so (P > 0.05). The hepatosomatic index (HSI) differed significantly in the two groups (P < 0.05), and the metabolomics results showed that a high carbohydrate intake induced significant increases in plasma α/β-glucose, succinate, and tyrosine, which could increase hepatic glycogen and triglyceride. Low levels of betaine were also found in the livers of the HCBD group. The histology and blood biochemistry results suggested abnormal liver, with excessive lipid accumulation and liver damage. A transcriptome analysis and quantitative reverse transcription–PCR (RT–qPCR) indicated that the expression of the factors INSR, IRS, PI3K, PDK, AKT, ACC, IL6, AP1, ChREBP-MLX, PEPCK, and FBP in the insulin signaling pathway was significantly upregulated and that of SOCS3, GSK3β, and AMPK significantly downregulated in the HCBD. This pattern is associated with the nonalcoholic fatty liver disease (NAFLD) pathway. This study extends our understanding of how high carbohydrate causes increased fat deposition in the liver, enhanced glycolysis (α/β-glucose) in the plasma, and reduced betaine in the liver. This leads to activation of hepatocyte insulin resistance and lipogenesis by regulating the expression of genes related to fatty liver disease.