An overview of the Publicly Funded Medical Education System in Taiwan

Jen-Hung Yang,Chung-Liang Shih 대한의사협회 의료정책연구소 2020 의료정책포럼 Vol.18 No.3

저자 楊仁宏教授(Jen-Hung Yang, MD, Ph D)는 대만 양명의대 공비생으로 입학하여 피부과 전문의가 되고 이후 대학교수와 타이완 ‘추치(慈濟 Tzu Chi) 의대학장’을 역임하고, 현재 彰化基督教醫院의 교육주임과 카오슝의과대학 교수로 재직하고 있다. 우리나라에서 논의되고 있는 공공의대를 몸소 경험하고 졸업생으로서 공공의대에 대한 의견을 기술하고 있다. 타이완은 1975년 정부 주도로 취약지역과 제대 군인을 위한 ‘원호 의료’ 등을 목적으로 하는 현재 우리나라의 공공의료대학의 설립취지와 동일한 ‘국립양명의대(國立陽明大學)’를 설립하였다. 양명의대는 입학생 모두를 ‘공비(公費) 장학생’으로 선발하였고 등록금과 생활비까지 지원했다. 그럼에도 1988년에 자비로 부담하는 일반 학생의 입학도 허용하기 시작하였고 이후 단독 의과대학에서 여러 보건의료계열을 거느린 국립양명대학교로 지난 1994년에 개편되었다. 저자는 현재까지 3가지 유형의 공비장학생과정에 대한 자세한 설명을 도표와 함께 하고 있다. 그럼에도 공통적인 것은 6년간의 의무기간 중 4년은 전공의교육 그리고 2년이 실제 취약지역, 공중보건, 국제보건 등의 직무를 위한 의무 복무 기간 이었다. 과거 별도로 1년간의 군복무 의무도 부여되었으나 지금은 군복무 기간이 4개월로 줄어들었다고 한다. 2년간의 의무 복무기간 면허는 개인 소유가 아니어서 양명대 학생들은 이에 헌법소원을 제기하였으나 2년간의 의무 복무기간 중 정부 차원의 면허의 관리는 ‘합헌’으로 판정받기도 하였다. 과거 장학금에 대한 1:1 배상을 하면 의무복무도 면제되었으나 최근 2016부터 자신이 공비(公費)로 받은 금액의 4배를 배상하여야 해제된다고 한다. 이것은 2016년부터 속칭 비인기과 전공을 지원하는 정책으로 입학전형이 바뀌었기 때문이다. 공비 장학생은 점차 줄기 시작하여 2009년에 와서는 소수 몇 명의 도서지방 출신 학생을 제외하고 학생 전원 자비 교육생으로 바뀌었다고 한다. 34년간의 공비학생제도가 자비학생으로 전환되었던 이유는 2년의 의무 복무로 더 이상 졸업생들을 보낼 지역이 없었다는 점이다. 지난 1982년~2017년 사이 양명대 졸업생 4,111명을 대상으로 한 취업 현황 파악을 살펴보면, 약 31.7%는 의료원에서, 38.5%는 지역병원, 29.8%는 1차(기층) 진료에 종사하고 있는 것으로 분석됐다. 총 6,557명의 졸업생 중 84%는 도시에 남았고, 전체 16%만이 취약지에 남았다. 양 교수는 도시와 시골간의 불균형은 공공의대로 해결할 수 없는 문제라고 지적하고 있다. 보다 더 정교한 공공성이 강화된 의학교육제도의 구축과 혁신이 필요함을 주장하고 있다. We briefly review the origin, planning, development, and outcome of the publicly funded medical education program (PFMP) in Taiwan. The general PFMP was launched in National Yang-Ming University School of Medicine in 1975. Approximately 6,600 PFMP graduates filled the gap of medical needs at that time, and at least a part (16%) of graduates still served at medically underserved areas. We demonstrated the contributions of the PFMPs to improve the healthcare in medically underserved areas and our public health system. We recognize that PFMP alone cannot overhaul the inadequacy of healthcare resources and physician supplies between the urban and rural underserved areas. We need more efforts and innovations to construct a more sophisticated public-funded medical education system to achieve an even and fair distribution of good healthcare resources.

Breviscapine Ameliorates Fear Extinction and Anxiety in BALB/cJ Mice

Wei Liang(Wei Liang),Jing Huang(Jing Huang),Shuya Yang(Shuya Yang),Peng Huang(Peng Huang),Jun Chen(Jun Chen),Chen Chen(Chen Chen),Qun Yang(Qun Yang),Fengzhan Li(Fengzhan Li) 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.3

Objective In this research, the influence of breviscapine on anxiety, fear elimination, and aggression and the potential mechanism was investigated. Methods Anxiety and locomotion were analyzed by elevated plus maze and open field test in mice. Bussey-Saksida Mouse Touch Screen Chambers were used to perform fear conditioning. Territorial aggression was assessed by resident intruder test. Protein levels were evaluated by Western blot. Breviscapine improved fear-extinction learning in BALB/cJ mice. Results Breviscapine at 20-100 mg/kg increased center cross number, total distance traveled, and velocity in a dose-dependent manner. On the other hand, breviscapine at 20-100 mg/kg decreased the immobility time in open field test. In addition, breviscapine at 20-100 mg/kg increased the ratio of time on the open arm, time on the distal parts of the open arm, and total distance traveled in elevated plus maze. Breviscapine at 100 mg/kg increased the average attack latency and decreased the number of attacks over the last 3 days of resident intruder test. In hippocampus, protein levels of postsynaptic density protein-95 and synaptophysin were elevated by breviscapine at these three doses. Conclusion The administration of breviscapine alleviates fear extinction, anxiety, and aggression, while increases locomotor in a dose-dependent manner, which might be associated with its influence on synaptic function.

Fenofibrate Increases Radiosensitivity in Head and Neck Squamous Cell Carcinoma via Inducing G2/M Arrest and Apoptosis

Liu, Jia,Ge, Yang-Yang,Zhu, Hong-Cheng,Yang, Xi,Cai, Jing,Zhang, Chi,Lu, Jing,Zhan, Liang-Liang,Qin, Qin,Yang, Yan,Yang, Yue-Hua,Zhang, Hao,Chen, Xiao-Chen,Liu, Zhe-Ming,Ma, Jian-Xin,Cheng, Hong-Yan,S Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.16

Radiation therapy is an important treatment for head and neck squamous cell carcinoma (HNSCC). However, how to promote radiation sensitivity in HNSCC remains a challenge. This study aimed to investigate the radiosensitizing effects of fenofibrate on HNSCC and explore the underlying mechanisms. HNSCC cell lines CNE-2 and KB were subjected to ionizing radiation (IR), in the presence or absence of fenofibrate treatment. Cell growth and survival, apoptosis and cell cycle were evaluated. In addition, CNE-2 cells were xenografted into nude mice and subjected to IR and/or fenofibrate treatment. The expression of cyclinB and CDK1 was detected by Western blotting. Our results showed that fenofibrate efficiently radiosensitized HNSCC cells and xenografts in mice, and induced apoptosis and G2/M arrest via reducing the activity of the CDK1/cyclinB1 kinase complex. These data suggest that fenofibrate could be a promising radiosensitizer for HNSCC radiotherapy.

CO2 capture and preparation of spindle-like CaCO3 crystals for papermaking using calcium carbide residue waste via an atomizing approach

Liang Ma,Tingyu Yang,Yu Wu,Xiaoqing Yue,Jinrong Yang,Shuai Zhang,Qiang Li,Jianbin Zhang 한국화학공학회 2019 Korean Journal of Chemical Engineering Vol.36 No.9

Spindle-like CaCO3 crystals with controllable sizes for papermaking were successfully prepared using CO2 (8% CO2/N2 mixture gas) and calcium carbide residue (CCR) waste, a by-product of acetylene gas and polyvinyl chloride production, as the raw materials by an atomization method at room temperature. The influences of solution concentration, reaction temperature, and gas/liquid flow rate ratios on the properties of the CaCO3 crystal were systematically investigated, and a possible atomization mechanism was proposed. The size of the as-prepared CaCO3 crystal with pure calcite phase was turned from 4.71×4.02 μm to 1.82×1.12 μm by adjusting the reaction conditions. The application of the as-prepared CaCO3 crystals from CCR waste as a filler for papermaking was explored. The R475 blue light whiteness of paper was increased from 77.3 to 80.6 with 11.4% CaCO3 crystals

IRE1α protects against osteoarthritis by regulating progranulin-dependent XBP1 splicing and collagen homeostasis

Liang Li,Zhang Fengmei,Feng Naibo,Kuang Biao,Fan Mengtian,Chen Cheng,Pan Yiming,Zhou Pengfei,Geng Nana,Li Xingyue,Xian Menglin,Deng Lin,Li Xiaoli,Kuang Liang,Luo Fengtao,Tan Qiaoyan,Xie Yangli,Guo Fen 생화학분자생물학회 2023 Experimental and molecular medicine Vol.55 No.-

Osteoarthritis (OA) is a full-joint, multifactorial, degenerative and inflammatory disease that seriously affects the quality of life of patients due to its disabling and pain-causing properties. ER stress has been reported to be closely related to the progression of OA. The inositol-requiring enzyme 1α/X-box-binding protein-1 spliced (IRE1α/XBP1s) pathway, which is highly expressed in the chondrocytes of OA patients, promotes the degradation and refolding of abnormal proteins during ER stress and maintains the stability of the ER environment of chondrocytes, but its function and the underlying mechanisms of how it contributes to the progression of OA remain unclear. This study investigates the role of IRE1α/ERN1 in OA. Specific deficiency of ERN1 in chondrocytes spontaneously resulted in OA-like cartilage destruction and accelerated OA progression in a surgically induced arthritis model. Local delivery of AdERN1 relieved degradation of the cartilage matrix and prevented OA development in an ACLT-mediated model. Mechanistically, progranulin (PGRN), an intracellular chaperone, binds to IRE1α, promoting its phosphorylation and splicing of XBP1u to generate XBP1s. XBP1s protects articular cartilage through TNF-α/ERK1/2 signaling and further maintains collagen homeostasis by regulating type II collagen expression. The chondroprotective effect of IRE1α/ERN1 is dependent on PGRN and XBP1s splicing. ERN1 deficiency accelerated cartilage degeneration in OA by reducing PGRN expression and XBP1s splicing, subsequently decreasing collagen II expression and triggering collagen structural abnormalities and an imbalance in collagen homeostasis. This study provides new insights into OA pathogenesis and the UPR and suggests that IRE1α/ERN1 may serve as a potential target for the treatment of joint degenerative diseases, including OA.

A Novel Social Aware Reverse Relay Selection Scheme for Underlaying Multi-Hop D2D Communications

Liang Li,Xinjie Yang,Yuanjie Zheng,Jiazhi Yang 한국인터넷정보학회 2023 KSII Transactions on Internet and Information Syst Vol.17 No.10

Device-to-Device (D2D) communication has received increasing attention and been studied extensively thanks to its advantages in improving spectral efficiency and energy efficiency of cellular networks. This paper proposes a novel relay selection algorithm for multi-hop full-duplex D2D communications underlaying cellular networks. By selecting the relay of each hop in a reverse manner, the proposed algorithm reduces the heavy signaling overhead that traditional relay selection algorithms introduce. In addition, the social domain information of mobile terminals is taken into consideration and its influence on the performance of D2D communications studied, which is found significant enough not to be overlooked. Moreover, simulations show that the proposed algorithm, in absence of social relationship information, improves data throughput by around 70% and 7% and energy efficiency by 64% and 6%, compared with two benchmark algorithms, when D2D distance is 260 meters. In a more practical implementation considering social relationship information, although the proposed algorithm naturally achieves less throughput, it substantially increases the energy efficiency than the benchmarks.

Adaptive Fuzzy Control for Teleoperation System with Uncertain Kinematics and Dynamics

Liang Yang,Yong Chen,Zhi Liu,Kairui Chen,Zixuan Zhang 제어·로봇·시스템학회 2019 International Journal of Control, Automation, and Vol.17 No.5

In this paper, we address the problem of adaptive tracking control for a teleoperation system with uncertainties in both kinematics and dynamics. Its solution is difficult to establish as the real control torque will be wrapped in the coupling of kinematic and dynamic uncertainties. To overcome this difficulty, we developed an adaptive control approach with the aid of fuzzy logic systems designed to approximate uncertain dynamics so that the real control can be separated from the coupling uncertainties. With our scheme, the boundedness of all the closed-loop signals is ensured, and at the same time the tracking errors go to a residual around zero as time tends to infinity. The effectiveness of the obtained results will be illustrated through experimental tests.

Emergence of Chinese Network Animation Drama

Yang Liang,Jaecheol Moon 중앙대학교 영상콘텐츠융합연구소 2019 TechArt :Journal of Arts and Imaging Science Vol.6 No.2

Research on the Characteristics of Chinese Network Animation Drama

Yang Liang,Jaecheol Moon 중앙대학교 영상콘텐츠융합연구소 2019 TechArt :Journal of Arts and Imaging Science Vol.6 No.4

'중국 애니메이션 학파’의 민족적 특징에 관한 연구

YANG LIANG 한국만화애니메이션학회 2020 만화애니메이션연구 Vol.- No.59

중국 애니메이션은 2015년 이래 <몽키킹: 영웅의귀환(大聖歸來)> <나의 붉은 고래(大魚海棠)> <백사:연기(白蛇:緣起)> <나타지마동강세(哪吒之魔童降世)> 등 애니메이션 개봉으로 흥행 수익은 물론 중국 스타일 애니메이션에 대한 기대감을 가지게 되었다. 2020년 개봉 예정인 <봉황(鳳凰)> <강자아(薑子牙)>와 에서도 중국 전통 스토리와 디자인을 볼 수 있다. 이 일련의 애니메이션 영화들은 세계화의 배경 아래 중국 특색인 ‘민족화’ 의미를 보여 주고 있다. 이러한 배경 아래 ‘중국 뉴 애니메이션 학파’나 ‘중국 애니메이션 학파’를 부흥시켜야 한다는 학자들의 주장이 많아지고 있다. 하지만 중국 애니메이션 역사에 등장했던 ‘중국 애니메이션 학파’에 대한 논제는 여전히 검토되어야 할 문제점으로 나타난다. 본 논문은 연구한 내용과 같이 주 문헌 자료와 탐방 연구법을 통해 중국 애니메이션 학파의 민족적 특징을 연구 분석하였다. 근년의 중국 애니메이션 미학과 산업 현황을 연구배경으로 기술하고 중국 애니메이션 민족화와 학파 간의 관계 문제를 제기하며 학계에서 게재된 논문을 선행연구로 논거 하였다. 논증하기 위해 ‘중국 애니메이션 학파’의 개념과 용어의 합리적 타당성을 검증하고, 이야기적 측면이나 미술 디자인, 움직임, 사운드 등 그 전통에서 의미를 연구하였다. 끝으로 중국 애니메이션 학파의 성공적 원인을 역사적 관점에서 정리하였고, 오늘날 중국의 뉴 애니메이션 산업성과 중국 내 시장을 중시해야 한다는 것을 시사점으로 주장하였다. Since 2015, the release of animations such as <Monkey King: Hero Is Back(2015)>,<Big Fish & Begonia(2016)> <White Snake(2019)>,<Ne Zha(2019)> has not only earned box office revenue, but has also caused Chinese audiences to love and remember the Chinese-style animation. <Phoenix> and <Legend of Deification> in 2020 also seek inspiration from traditional Chinese stories. In terms of art design, they made extensive reference to Chinese native culture. The release of this series of animated films shows a sign of “Nationalization” in the context of globalization. Under such circumstances, many Chinese scholars have raised the topic of “building the new Chinese animation school” or “rejuvenating the Chinese animation school.” However, the Chinese animation school that has appeared in the history of Chinese animation still has a lot of worthy of further study. Before hurriedly proposing the “Chinese New Animation School”, it is necessary to recognize the Chinese Animation School. This article mainly studies the national characteristics of the Chinese Animation School through literature surveys and interviews. The first is to take the current situation of animation in contemporary China as a research background. Later, the concept and rationality of the Chinese Animation School were demonstrated. It also analyzes the national characteristics of the Chinese animation school in terms of story, visual design, and sound. Finally, the reasons for the success of the Chinese animation school were summarized from a historical perspective. And this essay argued that today, China"s new animation industry and the market in China should be valued.