Delayed Airway Obstruction after Internal Jugular Venous Catheterization in a Patient with Anticoagulant Therapy

Delayed onset of neck hematoma following central venous catheterization without arterial puncture is uncommon. Herein, we present a patient who developed a delayed neck hematoma after repeated attempts at right internal jugular venous puncture and subsequent enoxaparin administration. Progressive airway obstruction occurred on the third day after surgery. Ultrasound examination revealed diffuse hematoma of the right neck, and fibreoptic examination of the airway revealed pharyngeal edema. After emergent surgical removal of the hematoma, the patient was extubated uneventfully

The role of trauma team activation by emergency physicians on outcomes in severe trauma patients

AbstractBackgroundIn our region, trauma team activation (TTA) is initiated by emergency physicians once an injured patient meets any of the criteria of TTA after the injured patient arrives at the emergency department (ED).PurposeTo evaluate the role of TTA on outcomes in patients with severe trauma.MethodsAll trauma patients who had injury severity score (ISS) >15 and were admitted from ED between January 2010 to December 2010 were included in the study. Mann–Whitney U test (non-normal distribution) or Student's t test (normal distribution) for continuous variables and Fisher exact test or Chi-square test for categorical variables were used to compare the statistically significant differences between TTA and non-TTA groups. Logistic regression was applied to determine any significant differences found in the statistical analysis for 30-day mortality.ResultsA total of 231 patients were signed up in the study. The TTA group had shorter time from ED to operation room (170 minutes vs. 534 minutes, p = 0.02) and tended to have more emergent operations (42.7% vs. 23.2%, p = 0.002). Emergent operation [odds ratio (OR), 0.34; 95% confidence interval (CI), 0.12–0.92, p = 0.035) was associated with lower mortality while ISS > 25 (OR, 7.48; 95% CI, 2.48–22.57, p < 0.0001), Glasgow coma scale score <13 (OR, 32.1; 95% CI, 4.30–94.6, p < 0.0001), hypotension (OR, 3.0; 95% CI, 1.1–7.9, p = 0.03), and coagulopathy (OR, 9.3; 95% CI, 1.2–71.4, p = 0.033) were associated with higher mortality.ConclusionThis study shows that TTA may shorten the time from ED to operation room in trauma patients with an ISS > 15

Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department

AbstractBackgroundTo increase the chance of restoring spontaneous circulation, cardiopulmonary resuscitation (CPR) with high-quality chest compressions is needed. We hypothesized that, in a municipal hospital emergency department, the outcome in nontraumatic out-of-hospital cardiac arrest patients treated with standard CPR followed by mechanical chest compression (MeCC) was not inferior to that followed by manual chest compression (MaCC). The purposes of the study were to test our hypothesis and investigate whether the use of MeCC decreased human power demands for CPR.MethodsA total of 455 consecutive out-of-hospital cardiac arrest patients of presumed cardiac etiology were divided into two groups according to the chest compressions they received (MaCC or MeCC) in this retrospective review study. Human power demand for CPR was described according to the Basic Life Support/Advanced Cardiovascular Life Support guidelines and the device handbook. The primary endpoint was recovery of spontaneous circulation during resuscitation, and the secondary endpoints were survival to hospital admission and medical human power demands.ResultsIn this study, recovery of spontaneous circulation was achieved in 33.3% of patients in the MeCC group and in 27.1% in the MaCC group (p = 0.154), and the percentages of patients who survived hospitalization were 22.2% and 17.6%, respectively (p = 0.229). A ratio of 2:4 for the human power demand for CPR between the groups was found. Independent predictors of survival to hospitalization were ventricular fibrillation/pulseless ventricular tachycardia as initial rhythm and recovery of spontaneous circulation.ConclusionNo difference was found in early survival between standard CPR performed with MeCC and that performed with MaCC. However, the use of the MeCC device appears to promote staff availability without waiving patient care in the human power-demanding emergency departments of Taiwan hospitals

Giant magneto-birefringence effect and tuneable colouration of 2D crystals' suspensions

One of the long sought-after goals in manipulation of light through light-matter interactions is the realization of magnetic-field-tuneable colouration, so-called magneto-chromatic effect, which holds great promise for optical, biochemical and medical applications due to its contactless and non-invasive nature. This goal can be achieved by magnetic-field controlled birefringence, where colours are produced by the interference between phase-retarded components of transmitted polarised light. Thus far birefringence-tuneable coloration has been demonstrated using electric field, material chirality and mechanical strain but magnetic field control remained elusive due to either weak magneto-optical response of transparent media or low transmittance to visible light of magnetically responsive media, such as ferrofluids. Here we demonstrate magnetically tuneable colouration of aqueous suspensions of two-dimensional cobalt-doped titanium oxide which exhibit an anomalously large magneto-birefringence effect. The colour of the suspensions can be tuned over more than two wavelength cycles in the visible range by moderate magnetic fields below 0.8 T. We show that such giant magneto-chromatic response is due to particularly large phase retardation (>3 pi) of the polarised light, which in its turn is a combined result of a large Cotton-Mouton coefficient (three orders of magnitude larger than for known liquid crystals), relatively high saturation birefringence (delta n = 2 x 10^-4) and high transparency of our suspensions to visible light. The work opens a new avenue to achieve tuneable colouration through engineered magnetic birefringence and can readily be extended to other magnetic 2D nanocrystals. The demonstrated effect can be used in a variety of magneto-optical applications, including magnetic field sensors, wavelength-tuneable optical filters and see-through printing.Comment: 10 pages, 4 figures. Nature Communications, 2020, Accepte

Serum leptin is associated with cardiometabolic risk and predicts metabolic syndrome in Taiwanese adults

<p>Abstract</p> <p>Background</p> <p>Leptin is associated with cardiovascular disease (CVD); however, few studies have assessed its relationship with metabolic syndrome, especially in an Asian population. Therefore, the aim of the present study was to assess leptin levels and evaluate its association with CVD and metabolic syndrome.</p> <p>Methods</p> <p>In 2009, 957 subjects, who underwent a routine physical examination and choose leptin examination, were selected to participate. Participants (269 females and 688 males) were stratified according to leptin level quartiles. Metabolic syndrome was defined by NCEP ATP III using waist circumference cutoffs modified for Asian populations, and CVD risk was determined using the Framingham Heart Study profile.</p> <p>Results</p> <p>Leptin levels were correlated with CVD risk in men and women. With the exception of fasting plasma glucose, increased leptin levels were observed as factors associated with metabolic syndrome increased in both males and females. After adjusting for age, an association between leptin levels and metabolic syndrome was observed. After adjusting for age alone or with tobacco use, subjects in the highest leptin quartile had a higher risk of having metabolic syndrome than those in the lowest quartile (OR = 6.14 and 2.94 for men and women, respectively). After further adjustment for BMI, metabolic syndrome risk remained significantly increased with increasing leptin quartiles in men. Finally, increased leptin levels were a predictor of metabolic syndrome in men and women.</p> <p>Conclusions</p> <p>Serum leptin levels are correlated with CVD risk and metabolic syndrome. Analysis of leptin as part of routine physical examinations may prove beneficial for early diagnosis of metabolic syndrome.</p

Using UWB Sensor for Delta Robot Vibration Detection

Abstract-This study proposed the ultra-wideband(UWB) sensor to detect the vibration of the delta robot and the distance between UWB sensor and robot arm. Based on the radar propagating principle and the proposed algorithm, the vibration status of robot arm can be obtained. Besides, the vibration status can be reduced by feedback the information to the controller of the robot arm. The advantage of the proposed sensor is that without contacting to the robot arm, UWB sensor is more flexible to be used and will not cause any unnecessary payload as accelerometers. With proper calibration, the simulation of vibration frequency and the real-time absolute position of the robot arm were calculated and demonstrated. The experimental results show that the correlations for measured frequency and distance approximate to 1

Improving Success Rates of Percutaneous Coronary Intervention for Chronic Total Occlusion at a Rural Hospital in East Taiwan

SummaryBackgroundWe aimed to report the results of percutaneous coronary intervention for chronic total occlusion (CTO) in a remote hospital of southeast Taiwan that does not have on-site coronary artery bypass graft support and has insufficient medical resources.MethodsFrom 2006 to 2009, we identified 96 patients who underwent percutaneous coronary intervention and whose coronary angiogram showed CTO lesions. On-site cardiovascular surgeons were unavailable from 2006 to 2009.ResultsThe success rate (test for trend, p = 0.02) and numbers of guidewires used (test for trend, p = 0.59) significantly increased from 2006 to 2009, and the procedural time reduced significantly (test for trend, p = 0.001). The volume of contrast media injected decreased, although this result was not statistically significant (p = 0.70).ConclusionOur experience in managing CTO lesions substantially improved and the procedural time reduced over 4 years, even when constrained by a relative shortage of medical resources

Giant magneto-birefringence effect and tuneable colouration of 2D crystal suspensions

From Springer Nature via Jisc Publications RouterHistory: received 2020-02-13, accepted 2020-07-03, registration 2020-07-10, pub-electronic 2020-07-24, online 2020-07-24, collection 2020-12Publication status: PublishedAbstract: One of the long-sought-after goals in light manipulation is tuning of transmitted interference colours. Previous approaches toward this goal include material chirality, strain and electric-field controls. Alternatively, colour control by magnetic field offers contactless, non-invasive and energy-free advantages but has remained elusive due to feeble magneto-birefringence in conventional transparent media. Here we demonstrate an anomalously large magneto-birefringence effect in transparent suspensions of magnetic two-dimensional crystals, which arises from a combination of a large Cotton-Mouton coefficient and relatively high magnetic saturation birefringence. The effect is orders of magnitude stronger than those previously demonstrated for transparent materials. The transmitted colours of the suspension can be continuously tuned over two-wavelength cycles by moderate magnetic fields below 0.8 T. The work opens a new avenue to tune transmitted colours, and can be further extended to other systems with artificially engineered magnetic birefringence

Exponentially selective molecular sieving through angstrom pores

Two-dimensional crystals with angstrom-scale pores are widely considered as candidates for a next generation of molecular separation technologies aiming to provide extreme, exponentially large selectivity combined with high flow rates. No such pores have been demonstrated experimentally. Here we study gas transport through individual graphene pores created by low intensity exposure to low kV electrons. Helium and hydrogen permeate easily through these pores whereas larger species such as xenon and methane are practically blocked. Permeating gases experience activation barriers that increase quadratically with molecules' kinetic diameter, and the effective diameter of the created pores is estimated as ~2 angstroms, about one missing carbon ring. Our work reveals stringent conditions for achieving the long sought-after exponential selectivity using porous two-dimensional membranes and suggests limits on their possible performance

Ultra-Violet Treatment for Fermenting Low-Salt Soya Sauce

Low-salt soya sauce has become a market trend due to consumers' demand for a low sodium diet life. In tradition, a low-salt soya sauce (with salt concentration below 14.4%) is made from a high-salt one (18% salt concentration) through diluting or reducing the sodium content. The post processing deteriorates the quality of the soya sauce produce as some specific, beneficial chemical components are inevitably removed. In production of a native-born low-salt soya sauce, a key problem encountered is possible microbial contamination that easily develops in a low salt environment. In this study, we evaluated the effect of ultra-violet (UVC 254nm) irradiation on soya mash of 12% salt concentration fermented at 35°C. The ultra-violet treatment could effectively prevent the soya mash from microbial contamination