Using graphical representations to enhance the quality-of-care for colorectal cancer patients.

The study was to enhance adherence to quality-of-care guidelines for colorectal cancer (CRC) patients through plotting graphical representations. Rasch analysis was performed to examine the unidimensional measurement of the 13 core indicators. An author-made Excel module was applied to plot the so-called Wright map and KIDMAP in education field to report physicians' adherence to the quality-of-life guidelines. We found that the scale of the quality-of-care guidelines for patients with colon cancer is unidimensional. A total of 15 (3.8%) and 14 (3.5%) persons' response patterns (i.e., Outfit MNSQs >2.0 and 4.0, respectively) are aberrantly dispersed from the majority of sample according to their estimated parameters of persons and indicators. It can be used for investigating the root cause of the 1ow measures and/or the most unexpected aberrant pattern of responses using Rasch analysis once any one indicator of unexpectedly aberrant treatment (p < .05) presents. The Rasch model can deal with these binary and/or missing data frequently seen in clinical settings. We confirm this computer module can contribute to ensuring that hospitals adhere to the treatment guidelines for patients with colon cancer.

Effects of an intervention on nutrition consultation for cancer patients.

We assessed whether cancer patients given a nutritional consultation by dietitians when discharged from the hospital experienced more health benefits than those not given a nutritional consultation. The McNemar test and the general linear model were used to examine the effect of nutrition intervention. A bubble chart was plotted to show the comparison between cancer groups. A total of 537 cancer patients discharged from a 1200-bed medical centre in Taiwan in 2011 were randomly divided into experimental and control groups. In the experimental group, nutritional status [evaluated using the Subjective Global Assessment (SGA) Classification technique], weight loss, and food intake recovery were significantly affected and returned to their usual levels, but in the control group, only food intake recovery was significantly affected. The effect of nutrition consultation intervention for cancer patients is thus evident. Significant positive effects were cancer-stage-dependent but not cancer-type-dependent. Future studies are recommended using the present study's methods to see whether the nutrition intervention effect occurs in cancer patients discharged from other hospitals throughout the world.

Using a bubble chart to enhance adherence to quality-of-care guidelines for colorectal cancer patients.

This study examines whether a higher rate of physician adherence to quality-of-care indicators for colorectal cancer patients is associated with improved survival and using a bubble chart to help interpret physician performance. A set of 13 core measures was used to evaluate the quality of care in 708 colorectal cancer patients treated from 2004 to 2007 at a hospital in Taiwan. A 100% adherence standard was used to measure the relationship of adherence to patient survival. Each indicator assigned by each cancer stage was dichotomously coded. The associations between the adherence and survival rates and demographic characteristics were assessed using Cox's proportional hazard regression. Physician adherence to core indicators was plotted using a bubble chart to motivate physicians' performance adhering to quality-of-care guidelines for colorectal cancer patients. The 100% adherence rate criterion contributed to a relatively low hazard ratio of 0.36 (95% confidence interval, 0.14-0.85; P= 0.02). The association between the adherence rate and survival indicated significant improvements for stage III patients compared with stage I patients. A graphical representation of bubble charts helped to monitor physician performance, which improved the adherence rate to quality-of-care guidelines for colorectal cancer patients.

A feasibility study on the predictive emission monitoring system applied to the Hsinta power plant of Taiwan Power Company.

The continuous emission monitoring system (CEMS) can monitor flue gas emissions continuously and instantaneously. However, it has the disadvantages of enormous cost, easily producing errors in sampling periods of bad weather, lagging response in variable ambient environments, and missing data in daily zero and span tests and maintenance. The concept of a predictive emission monitoring system (PEMS) is to use the operating parameters of combustion equipment through thermodynamic or statistical methods to construct a mathematic model that can predict emissions by a computer program. The goal of this study is to set up a PEMS in a gas-fired combined cycle power generation unit at the Hsinta station of Taiwan Power Co. The emissions to be monitored include nitrogen oxides (NOx) and oxygen (O2) in flue gas. The major variables of the predictive model were determined based on the combustion theory. The data of these variables then were analyzed to establish a regression model. From the regression results, the influences of these variables are discussed and the predicted values are compared with the CEMS data for accuracy. In addition, according to the cost information, the capital and operation and maintenance costs for a PEMS can be much lower than those for a CEMS.

Simultaneous absorption of SO2 and NO from flue gas with KMnO4/NaOH solutions.

The wet scrubbing combined SOx/NOx removal system is an advanced air pollution control device. This study attempts to understand the absorption kinetics in the system. The absorption of diluted SO2 and simultaneous absorption of diluted SO2 and NO, as occurs in flue gases, in a stirred tank reactor with KMnO4/NaOH solutions were carried out at 50 degrees C. The liquid-side and gas-side mass transfer coefficients of the system were determined. The results indicate that the absorption of SO2 is close to completely gas-film controlled where the NaOH concentration is greater than 0.1 M or the KMnO4 concentration is greater than 0.05 M. The increasing gas flow rate has a positive effect on the absorption rate of SO2. The existence of O2 has no significant effect on the absorption rate of SO2. Adding SO2 would decrease the absorption rate of NO; however, the addition of NO has no effect on the absorption rate of SO2.

Spray scrubbing of the nitrogen oxides into NaClO2 solution under acidic conditions.

The operating conditions of this study were closed to the typical operating conditions of flue gas desulfurization system in the coal-fired power plant. The objective of this study was to investigate the absorption performance of lean NO in an aqueous solution of acidic sodium chlorite using a bench-scale spraying column. The NO conversion and NOx removal efficiency were increasing with the increasing NO concentration, retention time, sodium chlorite concentration, operating temperature, and decreasing initial pH of solution. As the sodium chlorite concentration were higher than 0.4 M, the NO conversion and NOx removal efficiency were 100% and 80%, respectively. The NO conversion and NOx removal efficiency under initial pH 4-7 were higher than that of initial pH > 7. It meant that this process might be suitable to combining with traditional wet flue gas desulfurization system. As the NO2/NOx ratio in the effluent gas was closed to 0.5, it might be suitable to be absorbed in the second scrubbing column operated under alkaline condition.

The absorption kinetics of NO in NaClO2/NaOH solutions.

A combined wet scrubbing SOx/NOx removal system is an advanced air pollution control process. In this process, the mechanism of NO removal is relatively unknown. Consequently, absorption of NO by alkaline solutions of NaClO2 was studied to clarify the reaction kinetics. The experiments were carried out mainly at temperature 50 degrees C which is the common operating temperature for wet scrubbers. The assumption that the absorption occurred under the fast pseudo-mth reaction regime was verified in the experiments. The absorption rate of NO into NaClO2 solutions was found to be proportional to P(2)NO,0 and [NaClO2]0(2). The addition of NaOH to solutions of NaClO2 decreased the absorption rate of NO. The absorption rate of NO at 25 degrees C is lower than at 50 degrees C. In the study, the absorption rate of NO did not change with changing gas flow rates.

Removal of SO2 and NO from flue gas by wet scrubbing using an aqueous NaClO2 solution.

This study used a NaClO2/NaOH solution as the additive/absorbent to determine the extent of NOx removal in a wet scrubbing system. A combined SOx/NOx removal system was also tested. The experiments were performed in a bench-scale spraying sieve tray wet scrubber in a continuous mode. The operating variables included NO and SO2 concentrations, L/G ratio, molar ratio, and initial pH. The results of the individual DeNOx experiments show that the maximum DeNOx efficiencies ranged from 3.1 to 12.6%. The results of the combined DeSOx/DeNOx experiments show that the maximum DeNOx and DeSOx efficiencies ranged from 36.6 to 71.9% and from 89.4 to 100.0%, respectively. The major parameters affecting NOx removal efficiencies are the L/G ratio and the dosage of additive. The major parameter influencing DeSOx efficiencies is the L/G ratio.