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Importance-performance analysis (IPA) is a convenient tool for service quality evaluation. Likewise, SERVQUAL and the model of service quality is also another useful tool for service quality evaluation. How hot spring service providers position themselves and differentiate themselves from competitors is critical to their success. In this study, both IPA and SERVQUAL and the model of service quality are used to evaluate a hot spring service provider in Taiwan for comparisons. A modified SERVQUAL questionnaire was distributed to hot spring resort customers with 300 valid responses. Results from IPA indicated the “Reliability” as the service weakness, while SERVQUAL and the model of service quality identified the “Responsiveness” as the largest service gap. Using these tools, the service providers can identify the critical factors for improvements from different perspectives. Implications of both tools for service providers and researchers were discussed.

We describe a case of human herpes virus‐8‐associated primary effusion lymphoma (PEL) in a patient initially presented with fever, non‐productive cough and exertional dyspnoea. Physical examination revealed oral thrush, diminished breath sounds and dullness on percussion over the left hemithorax. A thoracic computed tomography (CT) revealed left‐sided massive pleural effusion without tumour masses or lymphadenopathy. The effusion was drained and cytology showed medium to large lymphoid cells, with prominent nucleoli and irregular nuclear contours. Meanwhile, his HIV was tested positive. Cell block immunostaining of the pleural effusion revealed these cells were CD45 (+), CD30 (+), MUM1 (melanoma‐associated antigen [mutated] 1) (+), LANA (latency‐associated nuclear antigen) (+) and EBER (Epstein–Barr virus‐encoded small RNAs) in situ hybridization (−). This case highlights the learning point that PEL in the setting of HIV/AIDS should be added in the differential diagnosis of patients with unexplained oropharyngeal candidiasis and malignant lymphomatous pleural effusion without a clear primary site., Here, we report a rare case of human herpes virus‐8‐associated primary effusion lymphoma in the setting of HIV/AIDS presenting with fever, oral thrush and malignant lymphomatous pleural effusion.

Background: Trichomonas vaginalis infection is one of the most widespread sexually transmitted infections in the world. There are approximately 276 million cases worldwide. Most men remain undiagnosed and untreated because they are asymptomatic. The chronic inflammation induced by persistent infection may increase the risk of developing genitourinary cancers. In this study, we aimed to investigate the association between trichomoniasis and benign prostate hyperplasia (BPH), prostate cancer (PCa), and bladder cancer (BC) in Taiwan.Material and method: We designed a case-control study by using the database of the National Health Insurance program in Taiwan. We used the International Classification of Diseases, 9th Revision classifications to classify all the medical conditions in the case and control groups. All odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using multivariable logistic regression to adjust for all comorbidities and variables.Result: From 2000 to 2015, we enrolled a total of 62,544 individuals as the case group and 187,632 as the control group. Trichomoniasis exposure had a significant association with BPH and PCa (adjusted OR: BPH = 2.685, 95% CI = 1.233–4.286, P = 0.013; PCa = 5.801, 95% CI = 1.296–26.035, P = 0.016). The relative risk was much higher if patients had both trichomoniasis and depression (adjusted OR = 7.682, 95% CI = 5.730–9.451, P < 0.001).Conclusion: Men with trichomoniasis had a significantly higher risk of developing BPH and PCa than those without. Healthcare professionals should not only pay more attention to disease treatment, but also to public health education.

Background Tuberculosis (TB) presents a global threat in the world and the lung is the frequent site of metastatic focus. A previous study demonstrated that TB might increase primary lung cancer risk by two-fold for more than 20 years after the TB diagnosis. However, no large-scale study has evaluated the risk of TB and secondary lung cancer. Thus, we evaluated the risk of secondary lung cancer in patients with or without tuberculosis (TB) using a nationwide population-based dataset. Methods In a cohort study of 1,936,512 individuals, we selected 6934 patients among patients with primary cancer and TB infection, based on the International Classification of Disease (ICD-p-CM) codes 010–011 from 2000 to 2015. The control cohort comprised 13,868 randomly selected, propensity-matched patients (by age, gender, and index date) without TB exposure. Using this adjusted date, a possible association between TB and the risk of developing secondary lung cancer was estimated using a Cox proportional hazards regression model. Results During the follow-up period, secondary lung cancer was diagnosed in 761 (10.97%) patients with TB and 1263 (9.11%) patients without TB. After adjusting for covariates, the risk of secondary lung cancer was 1.67 times greater among primary cancer in the cohort with TB than in the cohort without TB. Stratification revealed that every comorbidity (including diabetes, hypertension, cirrhosis, congestive heart failure, cardiovascular accident, chronic kidney disease, chronic obstructive pulmonary disease) significantly increased the risk of secondary lung cancer when comparing the TB cohort with the non-TB cohort. Moreover, the primary cancer types (including head and neck, colorectal cancer, soft tissue sarcoma, breast, kidney, and thyroid cancer) had a more significant risk of becoming secondary lung cancer. Conclusion A significant association exists between TB and the subsequent risk for metastasis among primary cancers and comorbidities. Therefore, TB patients should be evaluated for the subsequent risk of secondary lung cancer.

As design becomes more and more complicated, functional verification is getting challenging than ever. The challenges come in twofold: verification is taking longer to finish and difficult to catch all functional errors. Surveys[1] shown that functional error has been the number one reason for re-spin. How well verification is done becomes a very important issue. Re-spin not only can cost a lot due to advancing of manufacturing process but also delays the time to market which could be even more costly than re-spin itself. In order to tackle these two challenges, industry has come up with a solution called Universal Verification Methodology (UVM)[2] in recent years. But even with UVM which standardized the way for designing testbench, a simulation environment has to be well designed to take advantage of UVM and provide management of running large amount of simulations/regression in an efficient way.