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"Lin, Grace"
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Where the mountain meets the moon
Minli, an adventurous girl from a poor village, buys a magical goldfish, and then joins a dragon who cannot fly on a quest to find the Old Man of the Moon in hopes of bringing life to Fruitless Mountain and freshness to Jade River.
Book
Analyzing the Shortcomings in Smart Healthcare for Remote Home Care—A Case Study of the Taiwan Market
In Taiwan, remote healthcare initially focused on telemedicine, with systematic development starting in 2007 through the “Remote Care Pilot Program” and subsequent initiatives. Significant advancements came with the “Remote Health Care Services Development Plan” in 2010, which integratedArtificial intelligence and Information and communications technologies, enhancing smart healthcare in home care. This study investigated strategic gaps in smart healthcare applications for remote home care using a mixed-methods approach, particularly the Analytic Hierarchy Process (AHP). This study identified and ranked strategic gaps, including “legal regulations”, “economic factors”, “user behavior habits”, “policy and culture”, and “environment and technology”. Findings, based on in-depth interviews with 6 experts and 16 AHP questionnaire samples, highlight “legal regulations” and “user behavior habits” as critical areas needing attention. Addressing these gaps can improve user acceptance and the effectiveness of smart healthcare applications, providing valuable insights for future research and practice in making remote home care more comprehensive and efficient.
Journal Article
Starry River of the Sky
An innkeeper's chore boy discovers that a visitor's stories hold the key to returning the moon to the Starry River of the Sky.
Book
The Arabidopsis Lectin Receptor Kinase LecRK-V.5 Represses Stomatal Immunity Induced by Pseudomonas syringae pv. tomato DC3000
Stomata play an important role in plant innate immunity by limiting pathogen entry into leaves but molecular mechanisms regulating stomatal closure upon pathogen perception are not well understood. Here we show that the Arabidopsis thaliana L-type lectin receptor kinase-V.5 (LecRK-V.5) negatively regulates stomatal immunity. Loss of LecRK-V.5 function increased resistance to surface inoculation with virulent bacteria Pseudomonas syringae pv tomato DC3000. Levels of resistance were not affected after infiltration-inoculation, suggesting that LecRK-V.5 functions at an early defense stage. By contrast, lines overexpressing LecRK-V.5 were more susceptible to Pst DC3000. Enhanced resistance in lecrk-V.5 mutants was correlated with constitutive stomatal closure, while increased susceptibility phenotypes in overexpression lines were associated with early stomatal reopening. Lines overexpressing LecRK-V.5 also demonstrated a defective stomatal closure after pathogen-associated molecular pattern (PAMP) treatments. LecRK-V.5 is rapidly expressed in stomatal guard cells after bacterial inoculation or treatment with the bacterial PAMP flagellin. In addition, lecrk-V.5 mutants guard cells exhibited constitutive accumulation of reactive oxygen species (ROS) and inhibition of ROS production opened stomata of lecrk-V.5. LecRK-V.5 is also shown to interfere with abscisic acid-mediated stomatal closure signaling upstream of ROS production. These results provide genetic evidences that LecRK-V.5 negatively regulates stomatal immunity upstream of ROS biosynthesis. Our data reveal that plants have evolved mechanisms to reverse bacteria-mediated stomatal closure to prevent long-term effect on CO(2) uptake and photosynthesis.
Journal Article
When the sea turned to silver
\"Pinmei, a storyteller's granddaughter, must find the Luminous Stone that Lights the Night to rescue her grandmother, who has been kidnapped by the Tiger Emperor\"-- Provided by publisher.
Book
Local Digital Economic Growth, Enterprise Digital Transformation, and Digital Dividends: Evidence from China
Achieving digital transformation in enterprises is vital for advancing the digital economy. Using the World Bank’s China Enterprise Survey data, this study investigates how local digital economic growth impacts enterprise transformation. Findings suggest that higher local digital growth significantly boosts enterprise transformation, thereby improving short-term operations and long-term innovation. Remarkably, threshold regression reveals a stronger impact on larger enterprises and those with higher human capital. Additional analyses demonstrate that effective access to digital dividends enhances enterprises’ production, R&D, and management. These results offer guidance for local governments, supporting digital shifts and helping enterprises tailor transformation strategies.
Journal Article
Where the mountain meets the moon
Minli, an adventurous girl from a poor village, buys a magical goldfish, and then joins a dragon who cannot fly on a quest to find the Old Man of the Moon in hopes of bringing life to Fruitless Mountain and freshness to Jade River.
Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study
Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD.
This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis.
The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m(2), respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis.
Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.
Journal Article
A big mooncake for Little Star
Reimagines the cycles of the moon as a mother bakes a Big Moon Cookie and, despite Mama's request to wait, Little Star begins nibbling at it every night.
Book
Association of Device Industry Payments, Physician Supply, and Regional Utilization of Orthopedic and Cardiac Procedures
Background
Geographic variation in high-cost medical procedure utilization in the USA is not fully explained by patient factors but may be influenced by the supply of procedural physicians and marketing payments.
Objective
To examine the association between physician supply, medical device–related marketing payments to physicians, and utilization of knee arthroplasty (KA) and percutaneous coronary interventions (PCI) within hospital referral regions (HRRs).
Design
Cross-sectional analysis of data from the 2018 CMS Open Payments database and procedural utilization data from the CMS Provider Utilization and Payment database.
Participants
Medicare-participating procedural cardiologists and orthopedic surgeons.
Main Measures
Regional rates of PCIs and KAs per 100,000 Medicare fee-for-service (FFS) beneficiaries were estimated after adjustment for beneficiary demographics.
Key Results
Across 306 HRRs, there were 109,301 payments (value $17,554,728) to cardiologists for cardiac stents and 68,132 payments (value $40,492,126) to orthopedic surgeons for prosthetic knees. Among HRRs, one additional interventional cardiologist was associated with an increase of 12.9 (CI, 9.3–16.5) PCIs per 100,000 beneficiaries, and one additional orthopedic surgeon was associated with an increase of 20.6 (CI, 16.9–24.4) KAs per 100,000 beneficiaries. A $10,000 increase in gift payments from stent manufacturers was associated with an increase of 26.0 (CI, 5.1–46.9) PCIs per 100,000 beneficiaries, while total and service payments were not associated with greater regional PCI utilization. A $10,000 increase in total payments from knee prosthetic manufacturers was associated with an increase of 2.9 (CI, 1.4–4.5) KAs per 100,000 beneficiaries, while a similar increase in gift and service payments was associated with an increase of 14.5 (CI, 5.0–24.1) and 3.4 (CI, 1.6–5.2) KAs, respectively.
Conclusions
Among Medicare FFS beneficiaries, regional supply of physicians and receipt of industry payments were associated with greater use of PCIs and KAs. Relationships between payments and procedural utilization were more consistent for KAs, a largely elective procedure, compared to PCIs, which may be elective or emergent.
Journal Article