Yen-Ming Huang

A Portable Micro Gas Chromatography System for Lung Cancer Associated Volatile Organic Compound Detection

With the help of micro-electromechanical systems (MEMS) and complementary metal-oxide-semiconductor (CMOS) technology, a portable micro gas chromatography (μGC) system for lung cancer associated volatile organic compounds (VOCs) detection is realized for the first time. The system is composed of an MEMS preconcentrator, an MEMS separation column, and a CMOS system-on-chip (SoC). The preconcentrator provides a concentration ratio of 2170. The separation column can separate more than seven types of lung cancer associated VOCs. The SoC is fabricated by a TSMC 0.35 μm 2P4M process including the CMOS VOCs detector, sensor calibration circuit, low-noise chopper instrumentation amplifier (IA), 10 bit analog to digital converter, and the microcontrol unit (MCU). Experimental results show that the system is able to detect seven types of lung cancer associated VOCs (acetone, 2-butanone, benzene, heptane, toluene, m-xylene, 1,3,5-trimethylbenzene). The concentration linearity is R2 = 0.985 and the detection sensitivity is up to 15 ppb with 1,3,5-trimethylbenzene.

5G New Radio: Waveform, Frame Structure, Multiple Access, and Initial Access

Different from conventional mobile networks designed to optimize the transmission efficiency of one particular service (e.g., streaming voice/ video) primarily, the industry and academia are reaching an agreement that 5G mobile networks are projected to sustain manifold wireless requirements, including higher mobility, higher data rates, and lower latency. For this purpose, 3GPP has launched the standardization activity for the first phase 5G system in Release 15 named New Radio (NR). To fully understand this crucial technology, this article offers a comprehensive overview of the state-of-the-art development of NR, including deployment scenarios, numerologies, frame structure, new waveform, multiple access, initial/random access procedure, and enhanced carrier aggregation (CA) for resource requests and data transmissions. The provided insights thus facilitate knowledge of design and practice for further features of NR.

Effects of a National Health Education Program on the Medication Knowledge of the Public in Taiwan

Background: The inappropriate use of medication and inadequate medication knowledge among the general population has long been a concern in Taiwan. One reason for the deficiencies might be the lack of an active role of pharmacists in educating the public. To rectify the situation, in 2002, the Bureau of Pharmaceutical Affairs, Department of Health of Taiwan, began to sponsor a national effort, titled Community Education Program on Medication Use, to involve the expertise of pharmacists in public education. Objective: To evaluate the effects of this education program by analyzing the changes in knowledge of drug therapy among the participating public. Methods: This was a single-group pre- and post-comparison study. Between September 2003 and January 2004, a total of 955 community residents enrolled in the pharmacist-facilitated education program offered at 31 community universities. The medication knowledge of the participants was evaluated before and after the program. Demographic variables that might affect the education outcomes of the program were also examined. Results: Medication knowledge at baseline was positively correlated with education level and negatively correlated with age. Females were more aware of drug-related information than were males. The participants showed a significant improvement in medication knowledge (p < 0.001) at the end of the program. The baseline knowledge score was the most important determinant of the improvement of the posttest score. Conclusions: A national education program facilitated by pharmacists can improve the medication knowledge of the participants. Pharmacists should be encouraged to play a proactive role in large-scale health education programs.

Heterogeneous LTE downlink spectrum access using embedded-GFDM

5G system features massive machine type communications (mMTC) participating cellular networks with different radio access technologies (RATs) for diverse applications. We investigate an LTE downlink band sharing with a 5G RAT whose subcarrier spacing is narrower than the normal subcarrier spacing (15kHz) defined in 4G OFDMA technology. This case is very important since many upcoming low-cost machines require backhaul signaling provided by widely-deployed LTE infrastructure and physical characterizations of the bands below 6 GHz for wide coverage and mobility support. However, in such heterogeneous spectrum access, the spectral sidelobe leakage caused by the legacy downlink transmission significantly interferes with the reception of the 5G signaling even when all users are perfectly synchronized. In this paper, a spectrum shaping method using embedded-GFDM waveform is therefore proposed to deal with this challenging issue. The proposed scheme warrants no impact on the signal detection of legacy receivers and gains much more spectrum efficiency compared to guard band utilization.

Association of health literacy and medication self-efficacy with medication adherence and diabetes control

Introduction The exact pathway linking health literacy, self-efficacy, medication adherence, and glycemic control for type 2 diabetes remains unclear. Understanding the relationship between patient factors, medication adherence, and lower glycated hemoglobin (HbA1c) may help patients better manage their disease. This study examined the association of health literacy and medication self-efficacy with self-reported diabetes medication adherence, and the association of health literacy, medication self-efficacy, and self-reported diabetes medication adherence with HbA1c of patients with type 2 diabetes. Methods This cross-sectional study utilized a face-to-face questionnaire at two family medicine clinics in a Midwestern state among 174 patients; subjects enrolled were at least 20 years old with diagnosed type 2 diabetes, prescribed at least one oral diabetes medicine, and understood English. Questionnaires were administered to assess the participants’: health literacy, using the Newest Vital Sign six-item questionnaire (NVS); self-efficacy for medication use, using the 13-item Self-Efficacy for Appropriate Medication Use Scale; and self-report medication adherence, using the eight-item Morisky Medication Adherence Scale. HbA1c values were obtained from participants’ electronic medical records. Multiple linear regressions were used to explore the association of health literacy and medication self-efficacy with both medication adherence and HbA1c level after controlling for all other covariates. Results Self-reported health status (β = 0.17, p = 0.015) and medication self-efficacy (β = 0.53, p < 0.001) were positively associated with diabetes medication adherence. Health literacy was neither associated with diabetes medication adherence (β = −0.04, p = 0.586) nor HbA1c (β = −0.06, p = 0.542). Lower diabetes medication adherence (β = −0.26, p = 0.008) and higher number of prescribed medications (β = 0.28, p = 0.009) were correlated with higher HbA1c. Conclusion Health literacy, as measured by the NVS, does not correlate with medication adherence or glycemic control among patients with type 2 diabetes. Interventions to improve patients’ self-efficacy of medication use may improve diabetes medication adherence.

Quick screen of patients' numeracy and document literacy skills: the factor structure of the Newest Vital Sign

Introduction The Newest Vital Sign (NVS) is a survey designed to measure general health literacy whereby an interviewer asks six questions related to information printed on a nutritional label from an ice cream container. It enables researchers to evaluate several health literacy dimensions in a short period of time, including document literacy, comprehension, quantitative literacy (numeracy), application, and evaluation. No study has empirically examined which items belong to which latent dimensions of health literacy in the NVS using factor analysis. Identifying the factor structure of the NVS would enable health care providers to choose appropriate intervention strategies to address patients’ health literacy as well as improve their health outcomes accordingly. This study aimed to explore the factor structure of the NVS that is used to assess multiple dimensions of health literacy. Methods A cross-sectional study administering the NVS in a face-to-face manner was conducted at two family medicine clinics in the USA. One hundred and seventy four individuals who participated were at least 20 years old, diagnosed with type 2 diabetes, prescribed at least one oral diabetes medicine, and used English as their primary language. Exploratory factor analysis and confirmatory factor analysis were conducted to investigate the factor structure of the NVS. Results Numeracy and document literacy are two dimensions of health literacy that were identified and accounted for 63.05% of the variance in the NVS. Internal consistency (Cronbach’s alpha) of the NVS were 0.78 and 0.91 for numeracy and document literacy, respectively. Conclusion Numeracy and document literacy appropriately represent the factor structure of the NVS and may be used for assessing health literacy in greater detail for patients with type 2 diabetes.

Matrix Characterization for GFDM: Low Complexity MMSE Receivers and Optimal Filters

In this paper, a new matrix-based characterization of generalized-frequency-division-multiplexing (GFDM) transmitter matrices is proposed, as opposed to traditional vector-based characterization with prototype filters. The characterization facilitates deriving properties of GFDM (transmitter) matrices, including conditions for GFDM matrices being nonsingular and unitary, respectively. Using the new characterization, the necessary and sufficient conditions for the existence of a form of low-complexity implementation for a minimum mean square error (MMSE) receiver are derived. Such an implementation exists under multipath channels if the GFDM transmitter matrix is selected to be unitary. For cases where this implementation does not exist, a low-complexity suboptimal MMSE receiver is proposed, with its performance approximating that of an MMSE receiver. The new characterization also enables derivations of optimal prototype filters in terms of minimizing receiver mean square error (MSE). They are found to correspond to the use of unitary GFDM matrices under many scenarios. The use of such optimal filters in GFDM systems does not cause the problem of noise enhancement, thereby demonstrating the same MSE performance as orthogonal frequency division multiplexing. Moreover, we find that GFDM matrices with a size of power of two are verified to exist in the class of unitary GFDM matrices. Finally, while the out-of-band (OOB) radiation performance of systems using a unitary GFDM matrix is not optimal in general, it is shown that the OOB radiation can be satisfactorily low if parameters in the new characterization are carefully chosen.

Refining Prescription Warning Labels Using Patient Feedback: A Qualitative Study

The complexity of written medication information hinders patients’ understanding and leads to patient misuse of prescribed medications. Incorporating patient feedback in designing prescription warning labels (PWLs) is crucial in enhancing patient comprehension of medication warning instructions. This qualitative study explored patient feedback on five newly designed PWLs. In-depth semi-structured face-to-face interviews were conducted with 21 patients, who were 18 years and older, spoke English, and took a prescription medication. These patients were shown different variations of the five most commonly used PWLs-Take with Food, Do not Drink Alcohol, Take with a Full glass of Water, Do not Chew or Break, and Protect from Sunlight. The 60-minute interviews explored feedback on patient comprehension of the PWL instructions and their suggestions for improving the clarity of the PWLs. At the end of the interview, patient self-reported socio-demographic information was collected with a 3-minute survey and a brief health literacy assessment was completed using the Newest Vital Sign. Twenty-one patients completed the interviews. Most patients were female (n = 15, 71.4%) with ages ranging from 23 to 66 years old (mean: 47.6 ± 13.3). The mean health literacy score was 2.4 on a scale of 0–6. Qualitative content analysis based on the text, pictures, and placement of the PWLs on the pill bottle showed preferences for including ‘WARNING’ on the PWL to create alertness, inclusion of a picture together with the text, yellow color highlighting behind the text, and placement of the PWL on the front of the pill bottle. Although patients had positive opinions of the redesigned PWLs, patients wanted further improvements to the content and design of the PWLs for enhanced clarity and understandability.

Development and validation of a Chinese medication literacy measure

Despite the impact of medication literacy (ML) on patients’ safe use of medications, existing instruments are mostly for general health literacy measurement or designed for specific disease populations, with few specifically designed for ML.

21.5 A portable micro gas chromatography system for volatile compounds detection with 15ppb of sensitivity

Existing non-invasive lung cancer diagnostic equipment has difficulty in detecting early stage lung cancer as abnormal tissue is smaller than 0.5cm in size. According to studies showing that volatile organic compounds (VOCs) from human breath gas can provide biomarkers for human disease, especially for lung cancer, a non-invasive method was developed to measure the exhaled air from cancer patients using chromatography-mass spectrometry (GC-MS). However, traditional GC-MS equipment is very expensive and requires specialists to operate. In this research we demonstrate a portable micro gas chromatography (μGC) system to overcome the limitations of conventional methods and realize small chips for big data.