Changes in Outcome and Complication Rates of Very-low-birth-weight Infants in One Tertiary Center in Southern Taiwan Between 2003 and 2010

BackgroundNeonatal intensive care has changed dramatically over the past few decades and the survival of infants has generally improved in many countries. The purpose of this study was to explore the recent evolution of mortality and morbidities among very-low-birth-weight (VLBW) infants in southern Taiwan.MethodsWe retrospectively reviewed the medical records of VLBW (birth weight <1500 g) infants who were admitted to a neonatal intensive care unit at a tertiary medical center in southern Taiwan from 2003 to 2010. The study period was divided into two cohorts: the first cohort of 2003–2006 and the second cohort of 2007–2010. Demographic profiles and complications were recorded, including the following information: sex, birth body weight (BBW), gestational age (GA), Apgar score, patent ductus arteriosus (PDA), necrotizing enterocolitis, retinopathy, chronic lung disease (CLD), inguinal hernia, and sepsis. The length of stay (LOS) in hospital was compared between the two cohorts.ResultsA total of 420 (212 male) VLBW infants were enrolled with 52 (12.4%) deaths. Compared to surviving infants, deceased infants had significantly lower GA, Apgar scores, and BBW. The mortality of VLBW infants remained static between the two birth cohorts, but the incidence of major morbidities generally decreased. The LOS for overall surviving infants and the proportion of LOS > 60 days were both reduced in the period of 2007–2010. With further stratification by BBW, the major reduction of long LOS was only found in the group of BBW ≥ 1000 g. The multivariate logistic regression model found PDA, CLD, and BBW < 1000 g were major complications to be associated with long LOS among surviving infants.ConclusionPeriodic evaluation of the mortality and morbidity of preterm infants can help to understand the changes and trends of our neonatal care. Further study using the national dataset to provide more representative information is warranted

A novel algorithm for the signal interpolation of the displacement measurement based on a Fabry-Perot interferometer

Current commercial interferometers reveal excellent measurement performances, because of its major advantage which enables the displacement measurement with the characterization of the high resolution under the large measuring range. Fabry-Perot interferometer is a compact interferometer with the structure of common optical path. In comparison with the ordinary commercial laser interferometers having non-common optical path, Fabry-Perot interferometer is more insensitive to environmental disturbances. But the disadvantages of Fabry-Perot interferometer are the limited measuring range and the considerable visibility decadence of the interference pattern. To enlarge the measuring range, the folded Fabry-Perot interferometer in which a corner cube reflector severs as the measurement mirror has been proposed in the previous research. However, either the conventional Fabry-Perot interferometer or the folded Fabry-Perot interferometer still have the problem of the considerable visibility decadence of the interference pattern. When the length of optical cavity is changed, the overlapped state of the laser beams will be varied strongly. Hence, it is indispensible to offer a proper signal interpolation algorithm for various signal distributions during the displacement measurement in the whole measuring range. An advanced signal interpolation algorithm for the above-mentioned Fabry-Perot interferometer has been proposed in this investigation. The novel algorithm is able to solve the problem of the displacement measurement due to the considerable visibility decadence of the interference pattern. With this algorithm, a high precision displacement measurement in the large measuring range can be realized by the folded Fabry-Perot interferomete

Inhibitory effects of armepavine against hepatic fibrosis in rats

Activation of hepatic stellate cells (HSCs) plays a crucial role in liver fibrogenesis. armepavine (Arm, C19H23O3N), an active compound from Nelumbo nucifera, has been shown to exert immunosuppressive effects on T lymphocytes and on lupus nephritic mice. The aim of this study was to investigate whether Arm could exert anti-hepatic fibrogenic effects in vitro and in vivo. A cell line of rat HSCs (HSC-T6) was stimulated with tumor necrosis factor-α (TNF-α) or lipopolysaccharide (LPS) to evaluate the inhibitory effects of Arm. An in vivo therapeutic study was conducted in bile duct-ligated (BDL) rats. BDL rats were given Arm (3 or 10 mg/kg) by gavage twice daily for 3 weeks starting from the onset of BDL. Liver sections were taken for fibrosis scoring, immuno-fluorescence staining and quantitative real-time mRNA measurements. In vitro, Arm (1-10 μM) concentration-dependently attenuated TNF-α- and LPS-stimulated α-SMA protein expression and AP-1 activation by HSC-T6 cells without adverse cytotoxicity. Arm also suppressed TNF-α-induced collagen collagen deposition, NFκB activation and MAPK (p38, ERK1/2, and JNK) phosphorylations. In vivo, Arm treatment significantly reduced plasma AST and ALT levels, hepatic α-SMA expression and collagen contents, and fibrosis scores of BDL rats as compared with vehicle treatment. Moreover, Arm attenuated the mRNA expression levels of col 1α2, TGF-β1, TIMP-1, ICAM-1, iNOS, and IL-6 genes, but up-regulated metallothionein genes. Our study results showed that Arm exerted both in vitro and in vivo antifibrotic effects in rats, possibly through anti-NF-κB activation pathways

Tsengwen Reservoir Watershed Hydrological Flood Simulation Under Global Climate Change Using the 20 km Mesh Meteorological Research Institute Atmospheric General Circulation Model (MRI-AGCM)

Severe rainstorms have occurred more frequently in Taiwan over the last decade. To understand the flood characteristics of a local region under climate change, a hydrological model simulation was conducted for the Tsengwen Reservoir watershed. The model employed was the Integrated Flood Analysis System (IFAS), which has a conceptual, distributed rainfall-runoff analysis module and a GIS data-input function. The high-resolution rainfall data for flood simulation was categorized into three terms: 1979 - 2003 (Present), 2015 - 2039 (Near-future), and 2075 - 2099 (Future), provided by the Meteorological Research Institute atmospheric general circulation model (MRI-AGCM). Ten extreme rainfall (top ten) events were selected for each term in descending order of total precipitation volume. Due to the small watershed area the MRI-AGCM3.2S data was downsized into higher resolution data using the Weather Research and Forecasting Model. The simulated discharges revealed that most of the Near-future and Future peaks caused by extreme rainfall increased compared to the Present peak. These ratios were 0.8 - 1.6 (Near-future/Present) and 0.9 - 2.2 (Future/Present), respectively. Additionally, we evaluated how these future discharges would affect the reservoir¡¦s flood control capacity, specifically the excess water volume required to be stored while maintaining dam releases up to the dam¡¦s spillway capacity or the discharge peak design for flood prevention. The results for the top ten events show that the excess water for the Future term exceeded the reservoir¡¦s flood control capacity and was approximately 79.6 - 87.5% of the total reservoir maximum capacity for the discharge peak design scenario