Analysis of Revenue-Sharing Contracts for Service Facilities

Yeh, Ruey Huei,Lin, Yi-Fang Korean Institute of Industrial Engineers 2009 Industrial Engineeering & Management Systems Vol.8 No.4

There are customer services jointly provided by two facilities so that each customer will complete the course made up of both facilities' sub-services. The two facilities are assumed invested respectively by an infrastructure owner and one subordinate facility owner, whose partnership is built on their capital investments. This paper presents a mathematical model of Stackelberg competition between the two facility owners to derive their optimal Nash equilibrium. In this study, each facility owner's profit is consisted of fixed revenue fractions of sold services, operating costs (including depreciation cost) and maintenance costs of her facility. The maintenance costs of one facility are incurred both by failures and deterioration due to usage. Moreover, for both facilities, failures are rectified immediately by minimal repairs and preventive maintenance is carried out at a fixed time epoch. Additional assumptions are also employed to develop the model such as customer arrivals are manipulated to follow a Poisson process, and each facility's lifetime is independently Weibull-distributed. The Stackelberg game proceeds as follows. At the first stage of decision making process, the infrastructure owner (acting as a leader) decides the allocation of revenue shares based on her self-interest. After observing the allocation of revenue shares, the subordinate facility owner determines her own optimal price of services. This paper investigates actions and reactions of the two partners in the system. Then analytical conditions are proposed to achieve a unique optimal Nash equilibrium. Finally, some suggestions for further research are discussed.

Analysis of Revenue-Sharing Contracts for Service Facilities

Ruey Huei Yeh,Yi-Fang Lin 대한산업공학회 2009 Industrial Engineeering & Management Systems Vol.8 No.4

There are customer services jointly provided by two facilities so that each customer will complete the course made up of both facilities’ sub-services. The two facilities are assumed invested respectively by an infrastructure owner and one subordinate facility owner, whose partnership is built on their capital investments. This paper presents a mathematical model of Stackelberg competition between the two facility owners to derive their optimal Nash equilibrium. In this study, each facility owner"s profit is consisted of fixed revenue fractions of sold services, operating costs (including depreciation cost) and maintenance costs of her facility. The maintenance costs of one facility are incurred both by failures and deterioration due to usage. Moreover, for both facilities, failures are rectified immediately by minimal repairs and preventive maintenance is carried out at a fixed time epoch. Additional assumptions are also employed to develop the model such as customer arrivals are manipulated to follow a Poisson process, and each facility"s lifetime is independently Weibull-distributed. The Stackelberg game proceeds as follows. At the first stage of decision making process, the infrastructure owner (acting as a leader) decides the allocation of revenue shares based on her self-interest. After observing the allocation of revenue shares, the subordinate facility owner determines her own optimal price of services. This paper investigates actions and reactions of the two partners in the system. Then analytical conditions are proposed to achieve a unique optimal Nash equilibrium. Finally, some suggestions for further research are discussed.

Diagnostic Role of Serum Free-to-Total Prostate Specific Antigen (PSA) Ratio in Prostate Cancer with Serum Total Concentration of PSA below 4 ng/mL

Chang, Chih-Chun,Lee, Yi-Chen,Tsai, Huang-Wen,Yii, Shyi-Chun,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.13

Purpose: To examine the effectiveness of serum free-to-total prostate specific antigen ratio (%fPSA) for the detection of prostate cancer (PCa) in men with different serum total PSA (tPSA) categories. Materials and Methods: From January 2010 to December 2013, a total of 225 patients with lower urinary tract symptoms (LUTS) underwent tPSA and %fPSA measurements. Histological examination with calculation of Gleason score and whole body bone scans were performed in identified cases of PCa. Results: PCa was diagnosed in 44 (19.6%) patients and the remaining 181 patients had benign prostate disease. PCa was detected in 5 (23.8%), 13 (8.7%) and 26 (47.3%) cases with tPSA level ranges ${\leq}4ng/ml$, 4 to 10 ng/ml and >10 ng/ml, respectively. The average Gleason score was $7.2{\pm}0.2$. Some 6 (13.6%) out of 44 PCa patients had bone metastases. The sensitivity was 80% and specificity was 81.3% at the cut-off %fPSA of 15% in PCa patients with a tPSA level below 4 ng/mL. A lower %fPSA was associated with PCa patients with Gleason score ${\geq}7$ than those with Gleason score ${\leq}6$ ($11.7{\pm}0.98$ vs. $16.5{\pm}2.25%$, P=0.029). No obvious relation of %fPSA to the incidence of bone metastasis was apparent in this study. Conclusions: The clinical application of %fPSA could help to discriminate PCa from benign prostate disease in men with a tPSA concentration below 4 ng/mL.

Heart Rate Variability Biofeedback Increased Autonomic Activation and Improved Symptoms of Depression and Insomnia among Patients with Major Depression Disorder

I-Mei Lin,Sheng-Yu Fan,Cheng-Fang Yen,Yi-Chun Yeh,Tze‐Chun Tang,Mei-Feng Huang,Tai-Ling Liu,Peng-Wei Wang,Huang-Chi Lin,Hsin-Yi Tsai,Yu-Che Tsai 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2

Objective: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. Methods: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. Results: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. Conclusion: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.

Does Firm Location Affect Management Team Size and Reputation? Evidence from Taiwan

Yijie Tseng,Tsung-Kang Chen,Yu-Ting Hsieh,Yi-Fang Yeh 한국증권학회 2020 Asia-Pacific Journal of Financial Studies Vol.49 No.4

This study explores the effect of the location of a firm’s headquarters on the firm’s management team size and reputation (MS&R) in a geographically small country (i.e., Taiwan) with numerous founding family firms. The results show that firm location quality positively relates to MS&R, and the association becomes weaker when firm profitability is higher or the founding family is present in the firm. Furthermore, the effect of firm location quality on management team reputation (team size) becomes stronger (weaker) when the CEO position is held by the founding family. Finally, the results are robust when considering endogeneity issues and other model settings.

Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

Chang, Chih-Chun,Liou, Ching-Biau,Su, Ming-Jang,Lee, Yi-Chen,Liang, Chai-Ting,Ho, Jung-Li,Tsai, Huang-Wen,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

Impact of Peri-Operative Anemia and Blood Transfusions in Patients with Gastric Cancer Receiving Gastrectomy

Chang, Chih-Chun,Sun, Jen-Tang,Chen, Jing-Yuan,Chen, Yi-Ting,Li, Pei-Yu,Lee, Tai-Chen,Su, Ming-Jang,Wu, Jiann-Ming,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.

Comprehensive profiles and diagnostic value of menopausal-specific gut microbiota in premenopausal breast cancer

Hou Ming-Feng,Ou-Yang Fu,Li Chung-Liang,Chen Fang-Ming,Chuang Chieh-Han,Kan Jung-Yu,Wu Cheng-Che,Shih Shen-Liang,Shiau Jun-Ping,Kao Li-Chun,Kao Chieh-Ni,Lee Yi-Chen,Moi Sin-Hua,Yeh Yao-Tsung,Cheng Chi 생화학분자생물학회 2021 Experimental and molecular medicine Vol.53 No.-

In Western countries, breast cancer tends to occur in older postmenopausal women. However, in Asian countries, the proportion of younger premenopausal breast cancer patients is increasing. Increasing evidence suggests that the gut microbiota plays a critical role in breast cancer. However, studies on the gut microbiota in the context of breast cancer have mainly focused on postmenopausal breast cancer. Little is known about the gut microbiota in the context of premenopausal breast cancer. This study aimed to comprehensively explore the gut microbial profiles, diagnostic value, and functional pathways in premenopausal breast cancer patients. Here, we analyzed 267 breast cancer patients with different menopausal statuses and age-matched female controls. The α-diversity was significantly reduced in premenopausal breast cancer patients, and the β-diversity differed significantly between breast cancer patients and controls. By performing multiple analyses and classification, 14 microbial markers were identified in the different menopausal statuses of breast cancer. Bacteroides fragilis was specifically found in young women of premenopausal statuses and Klebsiella pneumoniae in older women of postmenopausal statuses. In addition, menopausal-specific microbial markers could exhibit excellent discriminatory ability in distinguishing breast cancer patients from controls. Finally, the functional pathways differed between breast cancer patients and controls. Our findings provide the first evidence that the gut microbiota in premenopausal breast cancer patients differs from that in postmenopausal breast cancer patients and shed light on menopausal-specific microbial markers for diagnosis and investigation, ultimately providing a noninvasive approach for breast cancer detection and a novel strategy for preventing premenopausal breast cancer.

The Effect of a Scenario-Based Spiritual Care Course on Spiritual Care Competence among Clinical Nurses

Suh-Ing Hsieh,Li-Ling Hsu,Hui-Ling Lin,Chen-Yi Kao,Yi-Ping Tseng,Li-Yun Szu,Ching-Yun Lee,Lun-Hui Ho,Shu-Ling Yeh,Shu-Hua Kao,Yen-Fang Chou,Tzu-Hsin Huang 한국성인간호학회 2021 성인간호학회 학술대회 Vol.2021 No.8

Aim(s): Clinical nurses are facing patients’ biopsychosocial and spiritual problems at diverse clinical settings, but they are lack of knowledge, skills, and confidence on providing spiritual care. However, no studies adopted simulated educational program and objective structure clinical examination (OSCE) to educate nurses and to assess the outcomes. Therefore, this study was to validate the effect of a scenario-based spiritual care course on spiritual care competence in clinical nurses. Methods: This non-equivalent quasi-experimental study with a pre-test and two post-tests (end of the intervention and three months later) was conducted between August 2019 and February 2021 (11 sessions). The recruitment posters with a QR code were distributed to different units at three branches of a large medical institute for recruiting clinical nurses, who provided direct patient care. The attendees of one-day scenario-based spiritual care course are the experimental group (n=53) and the control group (n=85) was matched with the experimental group (1:1-3 ratio) by similar units, ages, working experience, and clinical ladder. Instruments include basic information, self-evaluated and head nurses evaluated spiritual care competence scale (SCCS), spiritual perspective scale (SPS), and spiritual care perspective scale-revised (SCPSR) for both groups and reflective log, course satisfaction scale, OSCE checklist, and standardized patient feedback scale for the experimental group. The data were analyzed using descriptive statistics, repeated measures ANOVA, linear regression, and paired t test. Results: After controlling for pre-test scores and interest in attending spirituality/spiritual care, the experimental group showed significant higher SPS (p=0.012) and self-evaluated SCCS (p=0.002) and lower SCPSR (p=0.015) than the control group at the 2nd post-test. Repeated measure ANOVA also showed significant within-subject effects across three time points of the experimental group on SPS (p<0.001), SCPSR (p<0.001), and self-evaluated SCCS (p<0.001), but paired t test showed non-significant differences on SPS, SCPSR, and self-evaluated SCCS between pre-test and post-test with an exception of head nurse evaluated SCCS (p=0.035). The mean overall course satisfaction of the experimental group was 4.34±0.62. The mean global performance of OSCE was 3.40±0.91 and the majority of experimental group was pass (43.4%) and good (35.8%). 64.5% and 26.1% of standardized patients were partial and strongly agreed with examinees’ performance in spiritual care assessment respectively. Conclusions: The scenario-based spiritual care course is effectively to enhance clinical nurses’ spiritual care competence. It may cultivate clinical preceptors with better spiritual care pedagogy through simulation and OSCE for bedside teaching of nurse post-graduate year.