Dose pre-hospital laryngeal mask airway use has a survival benefit in non-shockable cardiac arrest?

Background. Whether pre-hospital laryngeal mask airway (LMA) use poses a survival benefit and should be approved as routine airway management in non-shockable cardiac arrest is of major concern. The present study examined the effectiveness of LMA, in comparison to other pre-hospital airway management on individuals who have experienced non-shockable cardiac arrest. Methods. Adult patients who experienced non-shockable cardiac arrest with activation of the emergency medical service (EMS) made up our study cohort in Taoyuan, Taiwan. The data were abstracted from EMS records and cardiac arrest registration protocols. Results. Among the 1912 enrolled patients, most received LMA insertion (72.4%), 108 (5.6%) bag-valve-mask (BVM) ventilation, 376 (19.7%) high-flow oxygen non-rebreather facemask, and only 44 (2.3%) received endotracheal tube intubation (ETI). With regard to survival to discharge, no significant differences in prevalence were evident among the groups: 2.8% of oxygen facial mask, 1.1% of BVM, 2.1% of LMA, and 4.5% of the ETI group survived to discharge (p = 0.314). In comparison to oxygen facial mask use, different types of airway management remained unassociated with survival to discharge after adjusting for variables by logistic regression analysis (BVM: 95% confidence interval [CI], 0.079 – 1.639 [p = 0.186]; LMA: 95% CI, 0.220–2.487 [p = 0.627]; ETI: 95% CI, 0.325–17.820 [p = 0.390]). The results of Hosmer-Lemeshow goodness-of-fit test of logistic regression model revealed good calibration. Conclusions. Pre-hospital LMA use was not associated with additional survival to discharge compared with facial oxygen mask, BVM, or ETI following non-shockable cardiac arrest

Establishing a risk scoring system for predicting erosive esophagitis

SummaryObjectiveThis study aims to establish a noninvasive scoring system to predict the risk of erosive esophagitis (EE).MethodsFrom 2002 to 2009, a total of 34,346 consecutive adults who underwent health check-ups and upper gastrointestinal endoscopy were retrospectively enrolled. Of the participants, 22,892 in the earlier two-thirds period of examination were defined as the training set and the remaining 11,454 as the validation set. EE was diagnosed by upper gastrointestinal endoscopy. Independent risk factors associated with EE were analyzed by multivariate analysis using a logistic regression model with the forward stepwise selection procedure in the training set. Subsequently, an EE risk scoring system was established and weighted by β coefficient. This risk scoring system was further validated in the validation set.ResultsIn the training set, older age, male gender, higher body mass index, higher waist circumference, higher serum triglyceride, and lower high-density lipid cholesterol levels were independent risk factors for predicting EE. According to the β coefficient value of each independent risk factor, the total score ranging from 0 to 10 was established, and then low- (0–3), moderate- (4–6), and high-risk (7–10) groups were identified. In the validation set, the prevalence rates of EE in the low-, moderate-, and high-risk groups were 5.15%, 15.76% and 26.11%, respectively (p < 0.001).ConclusionThis simple noninvasive risk scoring system, including factors of age, gender, body mass index, waist circumference, triglyceride, and high-density lipid cholesterol, effectively predicted EE and stratified its incidence

Determinants of the initial IPO performance: evidence from Hong Kong and Taiwan

The study examines the pricing determinants of initial public offerings (IPOs) in the Hong Kong and Taiwanese markets. Consistent with the literature, we find that the IPOs are underpriced in these two markets. Among the pricing determinants we examine, share allotment over the number of participating applicants appears to be the most important common factor. However, different IPO market characteristics do exist between the markets. We document that investment firms are underpriced while the trading and service firms are overpriced during the IPO events in Hong Kong. In contrast, liquidity appears to be positively related to the initial underpricing of IPO firms in Taiwan. Our evidence therefore supports the winner's curse model proposed by Rock (1986), and to some extent the liquidity theory by Booth and Chua (1996). The applicability and implications of our findings should also be of value to firms seeking external equities in these markets.

Characterization of the transcriptome of an ecologically important avian species, the Vinous-throated Parrotbill <it>Paradoxornis webbianus bulomachus</it> (Paradoxornithidae; Aves)

Abstract Background Adaptive divergence driven by environmental heterogeneity has long been a fascinating topic in ecology and evolutionary biology. The study of the genetic basis of adaptive divergence has, however, been greatly hampered by a lack of genomic information. The recent development of transcriptome sequencing provides an unprecedented opportunity to generate large amounts of genomic data for detailed investigations of the genetics of adaptive divergence in non-model organisms. Herein, we used the Illumina sequencing platform to sequence the transcriptome of brain and liver tissues from a single individual of the Vinous-throated Parrotbill, Paradoxornis webbianus bulomachus, an ecologically important avian species in Taiwan with a wide elevational range of sea level to 3100 m. Results Our 10.1 Gbp of sequences were first assembled based on Zebra Finch (Taeniopygia guttata) and chicken (Gallus gallus) RNA references. The remaining reads were then de novo assembled. After filtering out contigs with low coverage (P. w. bulomachus genome. Of 7,779 contigs retained for a top-hit species distribution analysis, the majority (about 86%) were matched to known Zebra Finch and chicken transcripts. We also annotated 6,365 contigs to gene ontology (GO) terms: in total, 122 GO-slim terms were assigned, including biological process (41%), molecular function (32%), and cellular component (27%). Many potential genetic markers for future adaptive genomic studies were also identified: 8,589 single nucleotide polymorphisms, 1,344 simple sequence repeats and 109 candidate genes that might be involved in elevational or climate adaptation. Conclusions Our study shows that transcriptome data can serve as a rich genetic resource, even for a single run of short-read sequencing from a single individual of a non-model species. This is the first study providing transcriptomic information for species in the avian superfamily Sylvioidea, which comprises more than 1,000 species. Our data can be used to study adaptive divergence in heterogeneous environments and investigate other important ecological and evolutionary questions in parrotbills from different populations and even in other species in the Sylvioidea.</p

Design of Feedback Control for Networked Finite-Distributed Delays Systems with Quantization and Packet Dropout Compensation

This paper investigates the feedback control for networked discrete-time finite-distributed delays with quantization and packet dropout, and systems induce the H∞ control problem. The compensation scheme occurs in a random way. The quantization of system state or output signal is in front of being communicated. It is shown that the design of both a state feedback controller and an observer-based output feedback controller can be achieved, which ensure the asymptotical stability as well as a prescribed H∞ performance of the resulting closed-loop system satisfying dependence on the size of the discrete and distributed delays. Numerical examples are given to illustrate the effectiveness and applicability of the design method in this paper

Hepatocellular Carcinoma With Presentation of Budd-Chiari Syndrome

Budd-Chiari syndrome is defined as hepatic venous outflow obstruction at any level from the small hepatic veins to the junction of the inferior vena cava and the right atrium independent of the underlying disease. We report here a 40-year-old male patient who complained of abdominal fullness and bilateral lower leg edema for 1 month. A physical examination disclosed bilateral lower leg edema. Abdominal sonography revealed a small amount of ascites with thrombosis of the inferior vena cava and right hepatic vein. Viral hepatitis marker tests showed positive hepatitis B surface antigen. Tumor markers showed elevated serum a-fetoprotein levels. Computed tomography and magnetic resonance imaging confirmed hepatocellular carcinoma with inferior vena cava and right hepatic vein thrombosis. Therefore, hepatocellular carcinoma with Budd-Chiari syndrome was diagnosed. The patient was treated with intravenous heparin, which was then changed to oral warfarin. Although it is relatively rare, clinicians should be aware of hepatocellular carcinoma with Budd-Chiari syndrome when leg edema occurs without hypoalbuminemia in patients with chronic hepatitis B, because these patients are in the high-risk group for developing hepatocellular carcinoma. Regular follow-up of chronic hepatitis B, including biochemical and sonography surveillance, should be performed

Citrus reticulata peel improves patient tolerance of low-volume polyethylene glycol for colonoscopy preparation

Background: Adequate adjuncts help to reduce the volume of polyethylene glycol-electrolyte lavage solution (PEG-ELS) needed, to ameliorate patient discomfort, and to improve colonic visibility during colonoscopy. This study aimed to assess the effect of Citrus reticulata peel (CRP) as an adjunct to low-volume PEG for colonic preparation. Methods: A total of 1092 health examination examinees received colonoscopy during the study period. After excluding those who refused to participate and those who did not meet our criteria, 212 examinees were enrolled into this study. They were divided into the PEG group and the PEG + CRP group according to their date of examination. All examinees received 2 L of PEG-ELS one day before colonoscopy. The PEG + CRP group also received additional CRP in the form of a “buccal tablet” between drinks. Tolerance and adverse events were assessed by questionnaire, while the quality of bowel preparation for colonoscopy was scored by an endoscopist. Results: There were 107 examinees in the PEG group and 105 examinees in the PEG + CRP group. The demographic characteristics of the examinees were comparable between these two groups. Examinees in the PEG + CRP group had a trend of better colonic visibility than those in the PEG group (p = 0.056). Moreover, examinees in the PEG + CRP group had higher rate of acceptable taste (p = 0.015) and lower rate of difficulty swallowing (p = 0.001). The incidences of adverse events including vomiting (p = 0.045), bloating (p = 0.035), and difficulty sleeping (p < 0.001) were also significantly lower in the PEG + CRP group. Conclusion: Compared with conventional colonic preparation, the application of CRP as an adjunct could improve examinees' tolerance, decrease the incidence of adverse events, and maintain the quality of colonic cleansing

High-Tg, Low-Dielectric Epoxy Thermosets Derived from Methacrylate-Containing Polyimides

Three methacrylate-containing polyimides (Px–MMA; x = 1–3) were prepared from the esterification of hydroxyl-containing polyimides (Px–OH; x = 1–3) with methacrylic anhydride. Px–MMA exhibits active ester linkages (Ph–O–C(=O)–) that can react with epoxy in the presence of 4-dimethylaminopyridine (DMAP), so Px–MMA acted as a curing agent for a dicyclopentadiene-phenol epoxy (HP7200) to prepare epoxy thermosets (Px–MMA/HP7200; x = 1–3) thermosets. For property comparisons, P1–OH/HP7200 thermosets were also prepared. The reaction between active ester and epoxy results in an ester linkage, which is less polar than secondary alcohol resulting from the reaction between phenolic OH and epoxy, so P1–MMA/HP7200 are more hydrophobic and exhibit better dielectric properties than P1–OH/HP7200. The double bond of methacrylate can cure at higher temperatures, leading to epoxy thermosets with a high-Tg and moderate-to-low dielectric properties