Abstract Adenomyosis of the uterus is defined as the presence of endometrial tissue, including glands and stroma, situated at least 2.5 mm below the endometrial–myometrial junction and widely ...distributed within the myometrium layer of the uterus. There is no consensus on the appropriate treatment for symptomatic uterine adenomyosis in women who want to preserve their uterus, partly because adenomyosis is somewhat enigmatic in diagnosis and owing to its clinical significance. Hysterectomy, through either exploratory laparotomy or minimally invasive procedures, is a definite treatment for uterine adenomyosis, once the women have completed childbirth or do not require future fertility. However, many women with a uterine pathology still have a strong desire to preserve the uterus, for which conservative and uterine-sparing procedures are increasingly used, and with which fertility preservation or quality-of-life improvement can be achieved. Although medical management can be effective, similar to the management of uterine fibroids (myoma), its effect is often transient and rapid regrowth of adenomyosis and relapse of symptoms and signs always occur once the treatment is stopped. Therefore, other strategies should be selected. Conservative and uterine-sparing surgery might be one of the most familiar procedures of these uterine-sparing procedures. In this article, the latest knowledge and research evidence on uterine-sparing surgery for uterine adenomyosis are reviewed.
The Taiwan Maternal and Infant Cohort Study (TMICS) was launched with the aim to assess the effects of prenatal exposure to phthalic acid esters (PAEs) on infant health. A total of 1102 pregnant ...women were enrolled in this study from 2012 to 2015. All participants completed a structured questionnaire, and provided urine specimens. The urinary concentrations of PAE metabolites in the third trimester were measured using liquid chromatography-electrospray ionization tandem mass spectrometry. Generalized additive model-penalized regression splines and logistic regression models were employed to determine the risk for low birth weight (LBW) or small for gestational age (SGA) among pregnant women exposed to PAEs. After adjustments for other covariates, each incremental unit of ln-transformed mono-n-butyl phthalate (MnBP) for pregnant women increased the odds of SGA in male neonates by 1.44 (95% CI: 0.92–2.23). An inverse association between SGA and maternal MnBP exposure level was observed in female neonates. An increase in one ln-transformed MnBP concentration unit decreased the risk of female SGA to 0.50 (95% CI: 0.24–0.97). In the penalized regression splines, increased risks of LBW/SGA in male neonates were presented while pregnant women exposed to increased MnBP levels. However, an association in the opposite direction was observed between maternal MnBP and LBW or SGA for male and female neonates.
This study indicated that high maternal MnBP exposure in the third trimester was associated with LBW or SGA for male infants. Adverse effects on susceptible populations exposed to high levels of PAEs should be of concern.
Display omitted
•The exposure profile of phthalates among pregnant women was presented.•A dose-response relationship existed between maternal MnBP level and LBW or SGA for male infants.•A negative but not significant association was observed between maternal MnBP and SGA for female neonate.
Abstract Objective The aim of this retrospective observational study was to determine the efficacy of carbetocin in reducing blood loss and primary postpartum hemorrhage (PPH) in vaginal and cesarean ...deliveries in a tertiary hospital in Taiwan. Materials and methods Eligible gravid women (27–41 weeks) with available data were categorized into those treated prophylactically with and without carbetocin. The primary outcome was blood loss and incidence of primary PPH as measured by intrapartum/intraoperative and postpartum (recovery room) blood loss. Results A total of 1069 deliveries were evaluated. Maternal age (∼31 years of age), body mass index (∼27 kg/m2 ) and parity (∼1.4) were similar among those treated with and without carbetocin for both vaginal and cesarean deliveries. The majority 749/1069 (70.1%) of deliveries were vaginal; a similar proportion of women undergoing vaginal 221/749 (29.5%) and cesarean 110/320 (34.4%) deliveries received prophylactic carbetocin for prevention of PPH. Among vaginal deliveries, there was no significant difference in intrapartum ( p = 0.083) or postpartum ( p = 0.925) blood loss, or incidence of PPH ( p = 0.092) between women with versus without carbetocin prophylaxis. However, there was a significant reduction in the intraoperative and total blood loss among cesarean deliveries with versus without carbetocin prophylaxis ( p < 0.001). The incidence of PPH was higher 84/320 (26.3%) among cesarean than among vaginal deliveries 62/749 (8.3%), but was significantly lower among cesarean deliveries with 18 (16.36%) versus without 66 (30.45%); p = 0.003 carbetocin prophylaxis. Conclusion In Taiwan, prophylactic use of carbetocin resulted in significantly less blood loss and incidence of PPH in cesarean than in vaginal deliveries.
Functional carbon materials have recently attracted attention as positive electrode active materials for Al rechargeable batteries in conjunction with an Al negative electrode and a chloroaluminate ...ionic liquid electrolyte. This study explores a new carbon material, a graphene-decorated activated carbon fiber cloth (ACFC), for the positive electrode. Graphene-decorated ACFCs can be used in a binder-free manner and will directly contribute to increased gravimetric capacity of the whole electrode mAh (gelectrode)−1, not per the active material. Specifically, the positive electrode behaviors of three types of ACFC-based electrodes are examined in a Lewis acidic AlCl3−1-ethyl-3-methylimidazolioum chloride (C2mimCl) room-temperature ionic liquid. Uncoated and low-loading graphene-coated ACFC electrodes show an electric double layer capacitor (EDLC)-like behavior, whereas the intercalation/deintercalation reaction of chloroaluminate anion (e.g., AlCl4−) is observed for the high-loading graphene-coated one. These electrodes exhibit a good cyclability and satisfactory coulombic efficiency up to 800 cycles at a current density of 500 mA g−1.
The contamination of a clouding agent with di(2-ethylhexyl) phthalate (DEHP), a substitute emulsifier-containing compound used in a variety of foods was announced on May 23, 2011. The aims of this ...study were as follows (1) compare the urine phthalates (PAE) metabolites concentration and estimate the daily intake (DI) of PAEs in pregnant women before and after the tainted food scandal and (2) examine the effect of relatively high PAEs exposure on birth outcome.
One-hundred twelve pregnant women in Northern Taiwan participated in this study from March to December 2010, i.e., before the tainted food scandal. After the tainted food scandal, we collected 69, 73, and 180 urine specimens (January 2013 to August 2014) from women whom were in their first, second, and third trimesters of pregnancy, respectively. We measure urinary DEHP metabolite concentrations to estimate the DI of DEHP and the hazard quotient (HQ) of subjects. This was the first study to assess the effects of DEHP-tainted food scandal exposure in pregnant women across the three trimesters of pregnancy.
After the tainted food report, the concentrations of urine PAE metabolite were significantly decreased, especially those of DEHP metabolites. Based on different reference limit values, the percentages of pregnant women whose HQDEHP value exceeded the limit ranged from 0.53% to 8.93%. Despite this low frequency, the higher ΣPAE exposure during the second trimester may significantly increase the risk of relatively low birth height compared to the lower exposure group (β=−0.63 (−1.20 to −0.06)).
Our results support the hypothesis that exposure to relatively high concentrations of DEHP in pregnant Taiwanese women may have an adverse effect on birth outcomes. The percentage of subjects whose exposure level exceeded the exposure limit was low; however, high PAEs exposure appears to be significantly associated with birth outcomes. Therefore, we suggest that reference dose for PAEs should be revised.
Display omitted
•After the scandal, the PAE metabolite concentrations were significantly decreased, especially those of DEHP metabolites.•The percentages of pregnant women whose hazard quotient of DEHP exceeded the reference limit ranged from 0.53% to 8.93%.•We found a negative association between the birth outcome birth height and PAE exposure during the second trimester.
Na1.56Fe1.22P2O7 was synthesized via a conventional solid-state method and evaluated as a positive electrode for Na secondary batteries using NaFSA-C3C1pyrrFSA (C3C1pyrr = ...N-methyl-N-propylpyrrolidinium and FSA = bis(fluorosulfonyl)amide) ionic liquids (IL) as electrolytes, over the temperature range of 298-363 K. A reversible capacity as high as 108 mAh g-1 has been achieved for the first time with a thermally stable IL at 363 K. This value is close to the theoretically calculated capacity of 118 mAh g−1 and is significantly higher than the previously reported values of ca. 85 mAh g−1 in organic electrolytes at 298 K. The capacity of 108 mAh g−1 also exceeds the value obtained for Na2FeP2O7 electrodes (94 mAh g−1) under the same experimental conditions. Moreover, excellent rate capability and superior cyclability exceeding 3000 cycles have been achieved by using the IL electrolyte over a wide temperature range of 298-363 K.
Unsupervised learning has grown in popularity because of the difficulty of collecting annotated data and the development of modern frameworks that allow us to learn from unlabeled data. Existing ...studies, however, either disregard variations at different levels of similarity or only consider negative samples from one batch. We argue that image pairs should have varying degrees of similarity, and the negative samples should be allowed to be drawn from the entire dataset. In this work, we propose Search-based Unsupervised Visual Representation Learning (SUVR) to learn better image representations in an unsupervised manner. We first construct a graph from the image dataset by the similarity between images, and adopt the concept of graph traversal to explore positive samples. In the meantime, we make sure that negative samples can be drawn from the full dataset. Quantitative experiments on five benchmark image classification datasets demonstrate that SUVR can significantly outperform strong competing methods on unsupervised embedding learning. Qualitative experiments also show that SUVR can produce better representations in which similar images are clustered closer together than unrelated images in the latent space.
Honeycomb layered oxides constitute an emerging class of materials that show interesting physicochemical and electrochemical properties. However, the development of these materials is still limited. ...Here, we report the combined use of alkali atoms (Na and K) to produce a mixed-alkali honeycomb layered oxide material, namely, NaKNi
TeO
. Via transmission electron microscopy measurements, we reveal the local atomic structural disorders characterised by aperiodic stacking and incoherency in the alternating arrangement of Na and K atoms. We also investigate the possibility of mixed electrochemical transport and storage of Na
and K
ions in NaKNi
TeO
. In particular, we report an average discharge cell voltage of about 4 V and a specific capacity of around 80 mAh g
at low specific currents (i.e., < 10 mA g
) when a NaKNi
TeO
-based positive electrode is combined with a room-temperature NaK liquid alloy negative electrode using an ionic liquid-based electrolyte solution. These results represent a step towards the use of tailored cathode active materials for "dendrite-free" electrochemical energy storage systems exploiting room-temperature liquid alkali metal alloy materials.
PDF
