Unusual case of spontaneous uterine rupture in a single gestational primipara

AbstractSpontaneous rupture of the primiparous uterus is a rare but catastrophic obstetrical emergency. It is usually associated with prior uterine surgery, trauma, or placental abnormality. To remind physicians to include this condition in their differential diagnosis of acute abdominal pain in pregnant patients, we describe an interesting case of spontaneous uterine rupture that clinically mimicked bowel perforation. A 27-year-old single primiparous pregnant woman presented with sudden onset of severe abdominal pain and peritoneal signs, with absence of vaginal bleeding at 26 weeks’ gestation. The usual risk factors for uterine rupture, such as advanced maternal age, scarred uterus due to mode of previous delivery, or unusual pregnancy, were not present in our patient. Based on clinical examination, abdominal sonography and magnetic resonance imaging, uterine rupture was suspected and eventually confirmed at exploratory laparotomy. No uterine pathological abnormality was noted on the microscopic examination The preterm newborn expired after surgery. Since surgical intervention is the only definitive treatment, emergency physicians should be aware of this rare complication. Emergency physicians should be aware of spontaneous uterine rupture in pregnant patients, even in the absence of risk factors

Design and implementation of a real-time global tone mapping processor for high dynamic range video

ABSTRACT As the development in high dynamic range (HDR

The role of reactive monomer in Pl-free technology for the alignment ability and image sticking performance

Polyimide-free technology is a technology in which an additive can replace polyimide film to align LC molecules. In this technology, the additive added in liquid crystal (LC) host can not only affect the alignment behavior, but also affect the reliability of the panel, such as image sticking. Because the polymer is polymerized from the additive in LC, the system of the additive is very important. In this paper, we studied the alignment and image sticking performance fabricated by two different additive systems: 1. the mixed system of additive and reactive monomer; 2. the single additive system. From the results of cell and 28” panel, we can conclude that the mixed system has similar alignment ability and voltage holding ratio to the single additive system, however, has better image sticking performance than the single additive system

Rhodiola crenulata extract for prevention of acute mountain sickness: a randomized, double-blind, placebo-controlled, crossover trial

BACKGROUND: Rhodiola crenulata (R. crenulata) is widely used to prevent acute mountain sickness in the Himalayan areas and in Tibet, but no scientific studies have previously examined its effectiveness. We conducted a randomized, double-blind, placebo-controlled crossover study to investigate its efficacy in acute mountain sickness prevention. METHODS: Healthy adult volunteers were randomized to 2 treatment sequences, receiving either 800 mg R. crenulata extract or placebo daily for 7 days before ascent and 2 days during mountaineering, before crossing over to the alternate treatment after a 3-month wash-out period. Participants ascended rapidly from 250 m to 3421 m on two separate occasions: December 2010 and April 2011. The primary outcome measure was the incidence of acute mountain sickness, as defined by a Lake Louise score ≥ 3, with headache and at least one of the symptoms of nausea or vomiting, fatigue, dizziness, or difficulty sleeping. RESULTS: One hundred and two participants completed the trial. There were no demographic differences between individuals taking Rhodiola-placebo and those taking placebo-Rhodiola. No significant differences in the incidence of acute mountain sickness were found between R. crenulata extract and placebo groups (all 60.8%; adjusted odds ratio (AOR) = 1.02, 95% confidence interval (CI) = 0.69–1.52). The incidence of severe acute mountain sickness in Rhodiola extract vs. placebo groups was 35.3% vs. 29.4% (AOR = 1.42, 95% CI = 0.90–2.25). CONCLUSIONS: R. crenulata extract was not effective in reducing the incidence or severity of acute mountain sickness as compared to placebo. TRIAL REGISTRATION: ClinicalTrials.gov NCT01536288

Mortality Predicted Accuracy for Hepatocellular Carcinoma Patients with Hepatic Resection Using Artificial Neural Network

The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC) patients undergoing resection between artificial neural network (ANN) and logistic regression (LR) models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation

Applying a Comprehensive Action Determination Model to Examine the Recycling Behavior of Taipei City Residents

With the occurrence of rapid global economic growth concerns about waste and its related effects on the environment are on the rise. There has been an increasing focus towards sustainable development and waste recycling as part of environmental sustainability strategies, and the encouraging of recycling behavior has received considerable attention from various environmental stakeholders. While numerous studies have used grounded theories such as the theory of planned behaviors and the norm activation model to examine environmental behaviors, a lack of consideration of other important variables in these studies has been revealed. This study aimed to address this gap by adopting the comprehensive action determination model, which comprises a wider group of influencing variables related to norms, intentions, situations, and habits. This model was tested using structural equation modelling with a sample of 386 valid questionnaires collected from Taipei City residents in the domain of recycling behaviors. Results indicated that awareness had a positive influence on personal norms towards recycling behaviors; social norms had a positive influence on personal norms towards recycling behaviors; attitudes had a positive influence on recycling intentions; social norms had a positive influence on recycling intentions; personal norms had a positive influence on recycling intentions; perceived behavior control had a positive influence on recycling intentions; recycling intentions had a positive influence on recycling behavior; and recycling habits had a positive influence on recycling behavior. However, findings did not support the positive impact of perceived behavioral control on recycling behavior

A 64-week, multicenter, open-label study of aripiprazole effectiveness in the management of patients with schizophrenia or schizoaffective disorder in a general psychiatric outpatient setting

<p>Abstract</p> <p>Objective</p> <p>To evaluate the overall long-term effectiveness of aripiprazole in patients with schizophrenia in a general psychiatric practice setting in Taiwan.</p> <p>Methods</p> <p>This was a prospective, open-label, multicenter, post-market surveillance study in Taiwanese patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia or schizoaffective disorder requiring a switch in antipsychotic medication because current medication was not well tolerated and/or clinical symptoms were not well controlled. Eligible patients were titrated to aripiprazole (5-30 mg/day) over a 12-week switching phase, during which their previous medication was discontinued. Patients could then enter a 52-week, long-term treatment phase. Aripiprazole was flexibly dosed (5-30 mg/day) at the discretion of the treating physicians. Efficacy was assessed using the Clinical Global Impression scale Improvement (CGI-I) score, the Clinical Global Impression scale Severity (CGI-S) score, The Brief Psychiatry Rating Scale (BPRS), and the Quality of Life (QOL) scale, as well as Preference of Medicine (POM) ratings by patients and caregivers. Safety and tolerability were also assessed.</p> <p>Results</p> <p>A total of 245 patients were enrolled and switched from their prior antipsychotic medications, and 153 patients entered the 52-week extension phase. In all, 79 patients (32.2%) completed the study. At week 64, the mean CGI-I score was 3.10 and 64.6% of patients who showed response. Compared to baseline, scores of CGI-S, QOL, and BPRS after 64 weeks of treatment also showed significant improvements. At week 12, 65.4% of subjects and 58.9% of caregivers rated aripiprazole as better than the prestudy medication on the POM. The most frequently reported adverse events (AEs) were headache, auditory hallucinations and insomnia. A total of 13 patients (5.3%) discontinued treatment due to AEs. No statistically significant changes were noted with respect to fasting plasma glucose, lipid profile, body weight, and body mass index after long-term treatment with aripiprazole.</p> <p>Conclusions</p> <p>Although the discontinuation rate was high, aripiprazole was found to be effective, safe and well tolerated in the long-term treatment of Taiwanese patients with schizophrenia who continued to receive treatment for 64 weeks.</p

The effect of exercise on the risk of metabolic syndrome associated with sleep insufficiency: a cross-sectional study

IntroductionSleep disturbance and insufficient sleep have been linked to metabolic syndrome, increasing cardiovascular disease and mortality risk. However, few studies investigate the joint effect of sleep and exercise on metabolic syndrome. We hypothesized that regular exercise can mitigate the exacerbation of metabolic syndrome by sleep insufficiency.ObjectiveThe aim of this study was to investigate whether exercise can attenuate or eliminate the relationship between sleep insufficiency and metabolic syndrome.MethodA total of 6,289 adults (mean age = 33.96 years; women: 74.81%) were included in the study, a cross-sectional study conducted based on the results of employee health screening questionnaires and databases from a large healthcare system in central Taiwan. Participants reported sleep insufficiency or not. Self-reported exercise habits were classified into 3 levels: no exercise, exercise &lt;150 min/week, and exercise ≧150 min/week. Multiple logistic regression and sensitivity analyses were conducted to understand the joint associations of sleep patterns and exercise with metabolic syndrome with exposure variables combining sleep duration/disturbances and PA.ResultsCompared with the reference group (sufficient sleep), individuals with sleep insufficiency had a higher risk for metabolic syndrome [adjusted odds ratio (AOR) = 1.40, 95% confidence interval (95% CI): 1.01–1.94, p &lt; 0.05] in females aged 40–64 years, but not in other populations. Sleep insufficiency was not associated with the risk of metabolic syndrome among individuals achieving an exercise level of &lt;150 min/week, and in particular among those achieving ≧150 min/week in all populations in our study.ConclusionSleep insufficiency was related to a higher risk of metabolic syndrome in female healthcare staff aged 40–64 years. Being physically active with exercise habits in these individuals, the risk of metabolic syndrome was no longer significant

One pot electrochemical synthesis of poly(melamine) entrapped gold nanoparticles composite for sensitive and low level detection of catechol

A simple and cost effective synthesis of nanomaterials with advanced physical and chemical properties have received much attention to the researchers, and is of interest to the researchers from different disciplines. In the present work, we report a simple and one pot electrochemical synthesis of poly(melamine) entrapped gold nanoparticles (PM-AuNPs) composite. The PM-AuNPs composite was prepared by a single step electrochemical method, wherein the AuNPs and PM were simultaneously fabricated on the electrode surface. The as-prepared materials were characterized by various physicochemical methods. The PM-AuNPs composite modified electrode was used as an electrocatalyst for oxidation of catechol (CC) due to its well-defined redox behavior and enhanced electro-oxidation ability towards CC than other modified electrodes. Under optimized conditions, the differential pulse voltammetry (DPV) was used for the determination of CC. The DPV response of CC was linear over the concentration ranging from 0.5 to 175.5 μM with a detection limit of 0.011 μM. The PM-AuNPs composite modified electrode exhibits the high selectivity in the presence of range of potentially interfering compounds including dihydroxybenzene isomers. The sensor shows excellent practicality in CC containing water samples, which reveals the potential ability of PM-AuNPs composite modified electrode towards the determination of CC in real samples