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Physical Sciences and Mathematics

2019

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Full-Text Articles in Medicine and Health Sciences

Mitochondria Imaging And Targeted Cancer Treatment, Tinghan Zhao Dec 2019

Mitochondria Imaging And Targeted Cancer Treatment, Tinghan Zhao

Dissertations

Mitochondria are essential organelles as the site of respiration in eukaryotic cells and are involved in many crucial functions in cell life. Dysfunction of mitochondrial metabolism and irregular morphology have been frequently found in human cancers. The capability of imaging mitochondria as well as regulating their microenvironment is important both scientifically and clinically. Mitochondria penetrating peptides (MPPs), certain peptides that are composed of cationic and hydrophobic amino acids, are good candidates for mitochondria targeting. Herein, a novel MPP, D-argine-phenylalanine-D-argine-phenylalanine-D-argine-phenylalanine-NH2 (rFrFrF), is conjugated with a rhodamine-based fluorescent chromophore (TAMRA). The TAMRA-rFrFrF probe exhibits advantageous properties for long-term mitochondria tracking of …


Computational Studies And Design Of Pparγ And Glut1 Inhibitors, Suliman Almahmoud Dec 2019

Computational Studies And Design Of Pparγ And Glut1 Inhibitors, Suliman Almahmoud

Theses & Dissertations

The peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-dependent transcription factor of the nuclear receptor superfamily that controls the expression of a variety of genes involved in fatty acid metabolism, adipogenesis, and insulin sensitivity. PPARγ is a target for insulin-sensitizing drugs, and it plays a significant function in prostate cancer. PPARγ antagonists have anti-proliferative effects in a broad range of hematopoietic and epithelial cell lines. The ligand binding domain (LBD) of PPARγ is large and has orthosteric and allosteric binding sites. Several PPARγ-ligand co-crystal structures show two bound molecules, one to the orthosteric pocket and a second to the allosteric …


Statistical Analysis Of Social Network Change, Teresa Danielle Schmidt Dec 2019

Statistical Analysis Of Social Network Change, Teresa Danielle Schmidt

Dissertations and Theses

This project explores two statistical methods that infer social network structures and statistically test those structures for change over time: regression-based differential network analysis (R-DNA) and information theory-based differential analysis (I-DNA). R-DNA is adapted from bioinformatics and I-DNA employs reconstructability analysis.

This project applies both R-DNA and I-DNA to analyze Medicaid claims data from one-year periods before (May 2011- Apr 2012) and after (Jan 2013-Dec 2013) the formation of the Health Share of Oregon Coordinated Care Organization (CCO). The formation of CCOs was legislated by the state of Oregon in 2012 with the triple aim of improving health outcomes, reducing …


Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay Dec 2019

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …


Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke Dec 2019

Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke

UNLV Theses, Dissertations, Professional Papers, and Capstones

An increasing number of treatment plants are required to remove nutrients from domestic wastewater to lessen the impact of nutrient loading to water bodies. Enhanced Biological Phosphorus Removal (EBPR) is one of the processes commonly used to remove phosphorus from domestic wastewater. The presence of an adequate quantity of volatile fatty acids (VFA) in the wastewater influent to EBPR is important for process efficiency and stability. The objective of this research was to investigate the production of VFAs through fermentation of sludge in primary clarifiers as it related to improving nutrient removal, primarily targeting phosphorus.

The research tested, in full-scale, …


Image Restoration Using Automatic Damaged Regions Detection And Machine Learning-Based Inpainting Technique, Chloe Martin-King Dec 2019

Image Restoration Using Automatic Damaged Regions Detection And Machine Learning-Based Inpainting Technique, Chloe Martin-King

Computational and Data Sciences (PhD) Dissertations

In this dissertation we propose two novel image restoration schemes. The first pertains to automatic detection of damaged regions in old photographs and digital images of cracked paintings. In cases when inpainting mask generation cannot be completely automatic, our detection algorithm facilitates precise mask creation, particularly useful for images containing damage that is tedious to annotate or difficult to geometrically define. The main contribution of this dissertation is the development and utilization of a new inpainting technique, region hiding, to repair a single image by training a convolutional neural network on various transformations of that image. Region hiding is also …


Probing Of Carbohydrate-Protein Interactions Using Galactonoamidine Inhibitors, Jessica B. Pickens Dec 2019

Probing Of Carbohydrate-Protein Interactions Using Galactonoamidine Inhibitors, Jessica B. Pickens

Graduate Theses and Dissertations

Glycoside hydrolases are ubiquitous and one of the most catalytically proficient enzymes known, and thus understanding their mechanisms are crucial. Most research has focused on the interaction of the glycon of substrates and their inhibitors within the active site of glycoside hydrolases. The inhibitors employed to probe these interactions generally had small aglycons (i.e. a hydrogen atom, amidines, small aliphatic groups, or benzyl groups). Here, the interactions of the aglycon with glycoside hydrolases are examined by probing the active sites with a library of 25 galactonoamidines. The studies described in this dissertation aim to increase the understanding of stabilization of …


Evaluation Of Relationship Between Lead-Dust Loading, Lead-Dust Concentration, And Total Dust Loading Metrics Across Multiple Data Sets, Charles Bevington Dec 2019

Evaluation Of Relationship Between Lead-Dust Loading, Lead-Dust Concentration, And Total Dust Loading Metrics Across Multiple Data Sets, Charles Bevington

Capstone Experience

Lead-dust monitoring studies report values as either lead-dust loadings µg/ft2 or as lead-dust concentrations µg/g. It is rare for studies to report both metrics. When only lead-dust loading values are present, professionals require an approach to estimate lead-dust concentration values. A literature search identified five studies that contained raw data for both lead-dust loading and lead-dust concentration. An additional thirty-two studies had summary-statistics available for both lead-dust loading and lead-dust concentration. Studies with raw-data were used to develop an empirically-based loading to concentration statistical relationship. Raw data sets were critically evaluated to determine whether elimination or …


A Signature Enrichment Design With Bayesian Adaptive Randomization For Cancer Clinical Trials, Fang Xia Dec 2019

A Signature Enrichment Design With Bayesian Adaptive Randomization For Cancer Clinical Trials, Fang Xia

Dissertations & Theses (Open Access)

Clinical trials in the era of precision medicine demand more flexible and efficient trial designs. Adaptive clinical trial designs allow pre-specified modifications of an on-going clinical trial and could shorten the trial duration. We reviewed five common types of adaptive clinical trials based on adaptation methods. In particular, outcome-randomization becomes more popular as it can assign more patients to the promising treatments based on the accumulated trial data. This data-driven allocation allows more patients to benefit from the trial, which is especially important for cancer patients. We compared different Bayesian outcome-adaptive randomization methods and discussed them from both methodological and …


Structure Elucidation Of A Pyrrolobenzodiazepine Alkaloid And A Biologically Active Polyketide Produced By Rhodococcus Sp. Mtm3w5.2 Via Two-Dimensional Nmr Spectroscopy, Garrett Johnson Dec 2019

Structure Elucidation Of A Pyrrolobenzodiazepine Alkaloid And A Biologically Active Polyketide Produced By Rhodococcus Sp. Mtm3w5.2 Via Two-Dimensional Nmr Spectroscopy, Garrett Johnson

Electronic Theses and Dissertations

As the battle against ever-increasing drug resistence bacteria rages on, novel and sometimes more complex natural products can be used to combat this. In this study, two-dimensional NMR techniques were utilized to collect a complete spectral data set for two natural products. The first structure, a synthesized Pyrrolobenzodiazepine alkaloid natural product was confirmed through these methods. The second, a strain of Rhodococcus, MTM3W5.2, produces a novel antibacterial molecule in broth cultures and the active compound was fractionated using a Sephedex LH-20 column. Chromatographic purification yielded a pure sample at 58.90 minutes, RT.58. HRMS data deduced an exact mass of …


Saponin Penetration And Interactions With Membranes, Sarai Guerrero Nov 2019

Saponin Penetration And Interactions With Membranes, Sarai Guerrero

Electronic Thesis and Dissertation Repository

The saponin QS21 has been used and studied for years as an adjuvant agent to improve vaccines for both humans and animals. However, how the saponin interacts with the membrane and itself remains poorly understood. We studied the QS21-A majority isomer using all-atom classical molecular dynamics simulations in model bilayers composed of cholesterol and either DOPC or DPPC. As this is one of the few computational studies on QS21-A, we had very few resources to compare our results to. Nevertheless, we were able to gain insight into possible configurations that QS21-A takes after penetration, the effect of the bilayer on …


Introducing A Mobile Health Care Platform In An Underserved Rural Population: Reducing Assimilations Gaps On Adoption And Use Via Nudges, Joseph Hodges Nov 2019

Introducing A Mobile Health Care Platform In An Underserved Rural Population: Reducing Assimilations Gaps On Adoption And Use Via Nudges, Joseph Hodges

USF Tampa Graduate Theses and Dissertations

Rural communities are often overlooked when it comes to offering cutting edge consumer healthcare technologies. Mobile applications usually exclude populations in rural demographics due to the infrastructure requirements and available technology in the region. The population studied is a low income rural health plan in southwest Georgia. They are uniquely considered as they have the highest healthcare costs in the U.S. and are compared to healthcare costs among higher income populations like Vail, Colorado. Innovations, such as mobile healthcare applications, have the capacity to offset some of these costs, but even if adoption occurs, this does not guarantee use will …


Deepcon-Pre: Improved Protein Contact Map Prediction Using Inverse Covariance And Deep Residual Networks, Nachammai Palaniappan Oct 2019

Deepcon-Pre: Improved Protein Contact Map Prediction Using Inverse Covariance And Deep Residual Networks, Nachammai Palaniappan

Theses

As with most domains where machine learning methods are applied, correct feature engineering is critical when developing deep learning algorithms for solving the protein folding problem. Unlike the domains such as computer vision and natural language processing, feature engineering is not rigorously studied towards solving the protein folding problem. A recent research has highlighted that input features known as precision matrix are most informative for predicting inter-residue contact map, the key for building three-dimensional models. In this work, we study the significance of the precision matrix feature when very deep residual networks are trained. Using a standard dataset of 3456 …


Protein Detection And Structural Characterization By Mass Spectrometry Using Supramolecular Assemblies And Small Molecules, Bo Zhao Oct 2019

Protein Detection And Structural Characterization By Mass Spectrometry Using Supramolecular Assemblies And Small Molecules, Bo Zhao

Doctoral Dissertations

Mass spectrometry (MS) has played an increasingly prominent role in proteomics and structure biology because it shows superior capabilities in identification, quantification and structural characterization of proteins. To realize its full potential in protein analysis, significant progress has been made in developing innovative techniques and reagents that can couple to MS detection. This dissertation demonstrates the use of polymeric supramolecular assemblies for enhanced protein detection in complex biological mixtures by MS. An amphiphilic random co-polymer scaffold is developed to form functional supramolecular assemblies for protein/ peptide enrichment. The influences of charge density and functional group pKa on host-guest interactions …


Game-Assisted Rehabilitation For Post-Stroke Survivors, Hee-Tae Jung Oct 2019

Game-Assisted Rehabilitation For Post-Stroke Survivors, Hee-Tae Jung

Doctoral Dissertations

Stroke is a leading cause of permanent impairments among its survivors. Although patients need to go through intensive, longitudinal rehabilitation to regain function before the stroke, patients show poor engagement and adherence to rehabilitation therapies which hampers their recovery. As a means to enhance stroke survivors' motivation, engagement, and adherence to intensive and longitudinal rehabilitation, the use of games in stroke rehabilitation has received attention from research and clinical communities. In order to realize this, it is important to take a holistic, end-to-end research approach that encompasses 1) the development of game technologies that are not only entertaining but also …


Sundaas Story: A Mixed-Methods Study Of Household Sanitation Provisioning In Urban Informal Housing In India, Sarita Vijay Panchang Oct 2019

Sundaas Story: A Mixed-Methods Study Of Household Sanitation Provisioning In Urban Informal Housing In India, Sarita Vijay Panchang

USF Tampa Graduate Theses and Dissertations

The aims of this research were to examine sanitation insecurity in urban informal housing through the lens of the built environment, social disparities, and health implications. While the Millennium Development Goals for halving the global proportion of people without access to safe drinking water were met ahead of schedule, progress fell short for sanitation, creating new objectives for the Sustainable Development Goals to be met in 2030. Much research in the Global South is dedicated to community-level sanitation promotion, but often presumes a rural rather than urban setting. Urban informal housing settings constitute a unique challenge due to the range …


Inference Of Language Functional Network In Healthy, Cancerous And Bilingual Brains By Fmri And Network Modeling, Qiongge Li Sep 2019

Inference Of Language Functional Network In Healthy, Cancerous And Bilingual Brains By Fmri And Network Modeling, Qiongge Li

Dissertations, Theses, and Capstone Projects

We study the underlying mechanism by which language processing occurs in the human brain using inference methods on functional magnetic resonance imaging data. The data analyzed stems from several cohorts of subjects; a monolingual group, a bilingual group, a healthy control group and one diseased case. We applied a complex statistical inference pipeline to determine the network structure of brain components involved with language. This healthy network reveals a fully connected triangular relationship between the pre-Supplementary Motor Area (pre-SMA), the Broca's Area (BA), and the ventral Pre-Motor Area (PreMA) in the left hemisphere. This "triangle'' shows consistently in all the …


Effective Statistical Energy Function Based Protein Un/Structure Prediction, Avdesh Mishra Aug 2019

Effective Statistical Energy Function Based Protein Un/Structure Prediction, Avdesh Mishra

University of New Orleans Theses and Dissertations

Proteins are an important component of living organisms, composed of one or more polypeptide chains, each containing hundreds or even thousands of amino acids of 20 standard types. The structure of a protein from the sequence determines crucial functions of proteins such as initiating metabolic reactions, DNA replication, cell signaling, and transporting molecules. In the past, proteins were considered to always have a well-defined stable shape (structured proteins), however, it has recently been shown that there exist intrinsically disordered proteins (IDPs), which lack a fixed or ordered 3D structure, have dynamic characteristics and therefore, exist in multiple states. Based on …


Development Of A Screening Method For Drugs Of Abuse By Direct Analysis Of Dried Urine Spots Coupled To Mass Spectrometry, Melanie Goldstein Aug 2019

Development Of A Screening Method For Drugs Of Abuse By Direct Analysis Of Dried Urine Spots Coupled To Mass Spectrometry, Melanie Goldstein

Student Theses

Fast and easy screening procedures are essential in any forensic toxicology laboratory to differentiate negative samples from presumptive positive cases. Immunoassay techniques, such as enzyme multiplied immunoassay technique (EMIT), are routinely employed as screening procedures. However, these techniques lack specificity (only differentiate group of drugs and not individual compounds) and it is difficult to add new compounds to the panel. Direct analysis of dried urine spots (DUS) by mass spectrometry (MS) offers a novel strategy to overcome these issues. DUS offer an improved storage alternative for biological samples, reducing costs and space requirements. In this work, an original method to …


Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson Aug 2019

Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eosinophilic esophagitis (EoE) is a rare immune-mediated illness with symptoms that range from difficulty swallowing to food impaction of the esophagus. Most published studies have been documented among patients residing in cool regions with significant annual rainfall. No published studies to our knowledge have been performed examining the healthcare utilization trends of EoE in Nevada. Utilizing two unique databases, the factors associated with EoE healthcare utilization patterns in Nevada were examined. All analyses were performed in R version 3.5.1. This study included a demographic and regional analysis identifying risk factors associated with having an EoE healthcare visit in Nevada. Several …


Modeling Proton Relative Biological Effectiveness Using Monte Carlo Simulations Of Microdosimetry, Mark A. Newpower Aug 2019

Modeling Proton Relative Biological Effectiveness Using Monte Carlo Simulations Of Microdosimetry, Mark A. Newpower

Dissertations & Theses (Open Access)

Proton therapy is a radiotherapy modality that can offer a better physical dose distribution when compared to photon radiotherapy by taking advantage of the Bragg peak, a narrow region of rapid energy loss. Proton therapy is also known to offer an enhanced relative biological effectiveness (RBE) compared to photons. In the current clinical standard, RBE is fixed at 1.1 at all points along the proton beam, meaning protons are assumed to require 10% less dose than photons to achieve target coverage and organ at risk (OAR) sparing. However, there is mounting clinical evidence, and a significant number of in vitro …


Quantifying Uncertainty In A Measurement-Based Assessment Of Relative Biological Effectiveness In Carbon Ion Radiotherapy, Shannon Hartzell Aug 2019

Quantifying Uncertainty In A Measurement-Based Assessment Of Relative Biological Effectiveness In Carbon Ion Radiotherapy, Shannon Hartzell

Dissertations & Theses (Open Access)

One of the largest inconsistencies in dose delivered during carbon ion therapy is due to uncertainties in relative biological effectiveness (RBE), a value that is calculated via one of several clinically implemented algorithms. This study investigates the uncertainty in measured microdosimetric parameters for RBE calculation by the Microdosimetric Kinetic Model (MKM), Repair Misrepair Fixation model (RMF), and Local Effect Model I (LEM) using a Tissue Equivalent Proportional Counter (TEPC).

Microdosimetric spectra, kinetic energy spectra, and dose fragment contributions were calculated using Monte Carlo (GEANT IV) for monoenergetic and SOBP carbon beams of clinical energy. From microdosimetric spectra, lineal energy values …


Commissioning Of Micro-Cube Thermoluminescent Dosimeters For Small Field Dosimetry Quality Assurance In Radiotherapy, Brandon Luckett Aug 2019

Commissioning Of Micro-Cube Thermoluminescent Dosimeters For Small Field Dosimetry Quality Assurance In Radiotherapy, Brandon Luckett

Dissertations & Theses (Open Access)

Small field dosimetry presents complications and uncertainties that could be circumvented by using detectors which are smaller than the radiation field. This study evaluates the reproducibility and accuracy of TLD micro-cubes for use in stereotactic radiosurgery (SRS) remote auditing quality assurance (QA) for treatment centers participating in clinical trials. This study tested the hypothesis that TLD micro-cubes could be commissioned to evaluate small field dosimetry, and provide reproducibility within 3%, as well as assure agreement between measured dose and calculated doses to within 5%.

The aims of this thesis were to characterize and commission TLD micro-cubes as well as to …


Investigating The Effects Of Social And Temporal Dynamics In Fitness Games On Children's Physical Activity, Ankita Samariya Aug 2019

Investigating The Effects Of Social And Temporal Dynamics In Fitness Games On Children's Physical Activity, Ankita Samariya

Boise State University Theses and Dissertations

Obesity in children has more than doubled in the last four decades. A variety of fitness technologies such as activity trackers, exergames, and mobile applications are available to promote physical activity, but few are designed adequately to meet children's specific needs. In my initial research, I found that children prefer having social interaction, a narrative, and flexibility while interacting with such technologies. Other research has shown that persuasive displays encouraged adults towards physical activity. As a part of this work, a collection of mobile applications, collectively known as KidFit Suite were developed. These applications encourage children to be physically active …


Association Of Copy Number Variations With Chronic Hepatitis B In Chinese Population, Fang Niu Aug 2019

Association Of Copy Number Variations With Chronic Hepatitis B In Chinese Population, Fang Niu

Capstone Experience

With one third of the Hepatitis B virus (HBV) infection population of the world, chronic Hepatitis B (CHB) has become a top burden in China. CHB is a lifelong infection with HBV which can cause serious health problems, like cirrhosis, liver cancer or even death. HBV infection is known to result in various clinical conditions, including asymptomatic HBV carriers to chronic hepatitis and primary hepatocellular carcinoma. Several studies have shown that host genetic susceptibility could be an important factor that determines these various outcomes of HBV infection. Many Single Nucleotide Polymorphisms (SNPs) and Copy Number Variations (CNVs) have been associated …


Successful Shot Locations And Shot Types Used In Ncaa Men’S Division I Basketball, Olivia D. Perrin Aug 2019

Successful Shot Locations And Shot Types Used In Ncaa Men’S Division I Basketball, Olivia D. Perrin

All NMU Master's Theses

The primary purpose of the current study was to investigate the effect of court location (distance and angle from basket) and shot types used on shot success in NCAA Men’s DI basketball during the 2017-18 season. A secondary purpose was to further expand the analysis based on two additional factors: player position (guard, forward, or center) and team ranking. All statistical analyses were completed in RStudio and three binomial logistic regression analyses were performed to evaluate factors that influence shot success; one for all two and three point shot attempts, one for only two point attempts, and one for only …


An Information Theory Model For Optimizing Quantitative Magnetic Resonance Imaging Acquisitions, Drew Mitchell Aug 2019

An Information Theory Model For Optimizing Quantitative Magnetic Resonance Imaging Acquisitions, Drew Mitchell

Dissertations & Theses (Open Access)

Quantitative magnetic resonance imaging (qMRI) is a powerful group of imaging techniques with a growing number of clinical applications, including synthetic image generation in post-processing, automatic segmentation, and diagnosis of disease from quantitative parameter values. Currently, acquisition parameter selection is performed empirically for quantitative MRI. Tuning parameters for different scan times, tissues, and resolutions requires some measure of trial and error. There is an opportunity to quantitatively optimize these acquisition parameters in order to maximize image quality and the reliability of the previously mentioned methods which follow image acquisition.

The objective of this work is to introduce and evaluate a …


Synthesis Of New Aliphatic Pseudo-Branched Polyester Co-Polymers For Biomedical Applications, Zachary Shaw Jul 2019

Synthesis Of New Aliphatic Pseudo-Branched Polyester Co-Polymers For Biomedical Applications, Zachary Shaw

Electronic Theses & Dissertations

In this study, a hyperbranched polyester co-polymer was designed using a proprietary monomer and diethylene glycol or triethylene glycol as monomers. The synthesis was carried out using standard melt polymerization technique and catalyzed by p-Tolulenesulfonic acid. The progress of the reaction was monitored with respect to time and negative pressure, with samples being subjected to standard characterization protocols. The resulting polymers were purified using the solvent precipitation method and characterized using various chromatographic and spectroscopic methods including GPC, MALDI-TOF, and NMR. We have observed polymers with a molecular weight of 29,643 kDa and 33,996 kDa, which is ideal to be …


Social Media Text Mining Framework For Drug Abuse: An Opioid Crisis Case Analysis, Tareq Nasralah Jul 2019

Social Media Text Mining Framework For Drug Abuse: An Opioid Crisis Case Analysis, Tareq Nasralah

Masters Theses & Doctoral Dissertations

Social media is considered as a promising and viable source of data for gaining insights into various disease conditions, patients’ attitudes and behaviors, and medications. The daily use of social media provides new opportunities for analyzing several aspects of communication. Social media as a big data source can be used to recognize communication and behavioral themes of problematic use of prescription drugs. Mining and analyzing such media have challenges and limitations with respect to topic deduction and data quality. There is a need for a structured approach to efficiently and effectively analyze social media content related to drug abuse in …


Early Information Access To Alleviate Emergency Department Congestion, Anjee Gorkhali Jul 2019

Early Information Access To Alleviate Emergency Department Congestion, Anjee Gorkhali

Theses and Dissertations in Business Administration

Alleviating Emergency Department (ED) congestion results in shorter hospital stay which not only reduces the cost of medical procedure but also increase the hospital performance. Length of patient stay is used to determine the hospital performance. Organization Information Processing (OIPT) Theory is used to explain the impact of information access and availability on the information processing need and ability of a hospital. Technical devices such as RFID that works as “Auto Identification tags” is suggested to increase the information availability as well as the information processing capability of the hospitals. This study suggests that the OIPT needs to be further …