Impact of climate change on disaster events in metropolitan cities -trend of disasters reported by Taiwan national medical response and preparedness system.

BACKGROUND: Taiwan is geographically located in a zone that is vulnerable to earthquakes, typhoons, floods, and landslide hazards and has experienced various disasters. Six Regional Emergency Medical Operation Centers (REMOCs) are integrated and administered by the Ministry of Health and Welfare (MOHW) to be responsible for emergency situations during disastrous events, such as the emission of chemical toxicants, traffic accidents, industrial materials containment, and typhoons. OBJECTIVE: To analyze events reported by the six REMOCs during the 2014 to 2018 for the government policy reference. METHODS: Data were collected from injured and death toll reports provided by local designated hospitals in the emergency medical reporting system. Disaster events were categorized into three categories: natural disaster (NDs), disasters associated with technology (DTs), and disasters associated with security/violence/others (DSVOs). The three categories were further subdivided into sub-categories. Variables considered for trend analyses included the number of wounded and deaths, event characteristics, date/time, and triage. The frequency of disaster events among the six REMOCs was compared using the chi-square test. We used the global information system (GIS) to describe the distribution of events in Taiwan metropolitan cities. The α-level was set at 0.05. RESULTS: Of 580 events during the study period, the distribution of disaster characteristics in the jurisdictions of the six REMOCs were different. The majority of disaster events were DTs (64.5%), followed by NDs (24.5%) and DSVOs (11.0%). Events for the three disaster categories in the six REMOCs were different (χ2-test, p < 0.001). Furthermore, for the Taipei branch (Northern Taiwan), other NDs, especially heatwaves and cold spells, were most reported in New Taipei City (92.2%) and showed an increasing annual trend; for the Kaohsiung branch (Southern Taiwan), DT events were the most reported, especially in Kaohsiung City; and for the Taichung branch (Central Taiwan), DSVOs were the most reported, especially in Taichung City. CONCLUSION: Our data revealed that extreme weather precautions reported in the Taipei branch were increasing. Disaster characteristics were different in each metropolitan city. Upgrading the ability to respond to natural disasters is ineluctable.

One-step synthesis of reduced graphene oxide sheathed zinc oxide nanoclusters for the trace level detection of bisphenol A in tissue papers.

After a long-term toxicity study on Bisphenol A (BPA), the European Union and U.S food and drug administration updating the rules regarding the usage of BPA by extending the prohibition of BPA to include in the production of papers, on February 2018. Therefore, it is essential to establish the trace level BPA detectors in paper samples. In this report, the synthesis of novel ZnO nanoclusters wrapped with reduced graphene oxide (ZnO NCs/rGO) and its application towards the selective electrocatalytic detection of BPA are described. Initially, ZnO NCs/rGO is synthesized by the one-step hydrothermal approach, and various characterizations explain the compound's compositions and structure. The significance of ZnO NCs/rGO together with good electrocatalytic properties leads this material to the platform for electrochemical sensor. Finally, ZnO NCs/rGO was fabricated and validated as an effective sensor for the sensitive detection of BPA. The demonstrated sensor revealed excellent detection of BPA with the very low detection limit (2.1 nM), and also it offered good analytical parameters with more extensive linear range and higher sensitivity. Likewise, the sensor annexes good durability, reproducibility, and selectivity towards the determination of BPA. Due to the nourishing capacity of the prepared ZnO NCs/rGO, it is employed for the detection of BPA in tissue paper samples.

A time-domain CMOS oscillator-based thermostat with digital set-point programming.

This paper presents a time-domain CMOS oscillator-based thermostat with digital set-point programming [without a digital-to-analog converter (DAC) or external resistor] to achieve on-chip thermal management of modern VLSI systems. A time-domain delay-line-based thermostat with multiplexers (MUXs) was used to substantially reduce the power consumption and chip size, and can benefit from the performance enhancement due to the scaling down of fabrication processes. For further cost reduction and accuracy enhancement, this paper proposes a thermostat using two oscillators that are suitable for time-domain curvature compensation instead of longer linear delay lines. The final time comparison was achieved using a time comparator with a built-in custom hysteresis to generate the corresponding temperature alarm and control. The chip size of the circuit was reduced to 0.12 mm2 in a 0.35-mm TSMC CMOS process. The thermostat operates from 0 to 90 °C, and achieved a fine resolution better than 0.05 °C and an improved inaccuracy of ± 0.6 °C after two-point calibration for eight packaged chips. The power consumption was 30 µW at a sample rate of 10 samples/s.

High-resolution electronic interferometry for the measurement of in-plane vibration.

This study proposes an algorithm based on the standard deviation in the temporal domain to remove influences from background noise and ambient disturbance and enhance the quality of images obtained using interferometric technology. From measurements of the first ten in-plane resonant frequencies and mode shapes of vibrating zirconate titanate (PZT) laminates, we investigated the resonant characteristics in both the U and V directions. The resulting interference fringes were used to quantify the vibration amplitude of PZT plates on a submicron scale. The resonant frequencies obtained using the proposed method are in excellent agreement with those obtained using the finite element method and an impedance analyzer.

Breast carcinoma-amplified sequence 2 regulates adult neurogenesis via ß-catenin.

BACKGROUND: Breast carcinoma-amplified sequence 2 (BCAS2) regulates ß-catenin gene splicing. The conditional knockout of BCAS2 expression in the forebrain (BCAS2 cKO) of mice confers impaired learning and memory along with decreased ß-catenin expression. Because ß-catenin reportedly regulates adult neurogenesis, we wondered whether BCAS2 could regulate adult neurogenesis via ß-catenin. METHODS: BCAS2-regulating neurogenesis was investigated by characterizing BCAS2 cKO mice. Also, lentivirus-shBCAS2 was intracranially injected into the hippocampus of wild-type mice to knock down BCAS2 expression. We evaluated the rescue effects of BCAS2 cKO by intracranial injection of adeno-associated virus encoding BCAS2 (AAV-DJ8-BCAS2) and AAV-ß-catenin gene therapy. RESULTS: To show that BCAS2-regulating adult neurogenesis via ß-catenin, first, BCAS2 cKO mice showed low SRY-box 2-positive (Sox2+) neural stem cell proliferation and doublecortin-positive (DCX+) immature neurons. Second, stereotaxic intracranial injection of lentivirus-shBCAS2 knocked down BCAS2 in the hippocampus of wild-type mice, and we confirmed the BCAS2 regulation of adult neurogenesis via ß-catenin. Third, AAV-DJ8-BCAS2 gene therapy in BCAS2 cKO mice reversed the low proliferation of Sox2+ neural stem cells and the decreased number of DCX+ immature neurons with increased ß-catenin expression. Moreover, AAV-ß-catenin gene therapy restored neuron stem cell proliferation and immature neuron differentiation, which further supports BCAS2-regulating adult neurogenesis via ß-catenin. In addition, cells targeted by AAV-DJ8 injection into the hippocampus included Sox2 and DCX immature neurons, interneurons, and astrocytes. BCAS2 may regulate adult neurogenesis by targeting Sox2+ and DCX+ immature neurons for autocrine effects and interneurons or astrocytes for paracrine effects. CONCLUSIONS: BCAS2 can regulate adult neurogenesis in mice via ß-catenin.

Improvement of Temperature and Optical Power of an LED by Using Microfluidic Circulating System of Graphene Solution.

Electric devices have evolved to become smaller, more multifunctional, and increasingly integrated. When the total volume of a device is reduced, insufficient heat dissipation may result in device failure. A microfluidic channel with a graphene solution may replace solid conductors for simultaneously supplying energy and dissipating heat in a light emitting diode (LED). In this study, an automated recycling system using a graphene solution was designed that reduces the necessity of manual operation. The optical power and temperature of an LED using this system was measured for an extended period and compared with the performance of a solid conductor. The temperature difference of the LED bottom using the solid and liquid conductors reached 25 °C. The optical power of the LED using the liquid conductor was higher than that of the solid conductor after 120 min of LED operation. When the flow rate was increased, the temperature difference of the LED bottom between initial and 480 min was lower, and the optical power of the LED was higher. This result was attributable to the higher temperature of the LED with the solid conductor. Moreover, the optical/electric power transfer rate of the liquid conductor was higher than that of the solid conductor after 120 min of LED operation, and the difference increased over time.

Oximetry as an Accurate Tool for Identifying Moderate to Severe Sleep Apnea in Patients With Acute Stroke.

STUDY OBJECTIVES: Sleep-disordered breathing (SDB) is highly prevalent in patients with acute stroke. SDB is often underdiagnosed and associated with neurological deterioration and stroke recurrence. Polysomnography or home sleep apnea testing (HSAT) is typically used as the diagnostic modality; however, it may not be feasible to use regularly in patients with acute stroke. We investigated the predictive performance of pulse oximetry, a simpler alternative, to identify SDB. METHODS: The records of 254 patients, who were admitted to Boston Medical Center for acute stroke and underwent HSAT, were retrospectively reviewed. Oxygen desaturation index (ODI) from pulse oximetry channel were compared to respiratory event index (REI) obtained from HSAT devices. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ODI were calculated, and different ODI cutoff values to predict SDB were proposed. RESULTS: ODI had a strong correlation (r = .902) and agreement with REI. ODI was accurate in predicting SDB at different REI thresholds (REI ≥ 5, REI ≥ 15, and REI ≥ 30 events/h) with the area under the curve (AUC) of .965, .974, and .951, respectively. An ODI ≥ 5 events/h rules in the presence of SDB (specificity 91.7%, PPV 96.3%). An ODI ≥ 15 events/h rules in moderate to severe SDB (specificity 96.4%, PPV 95%) and an ODI < 5 events/h rules out moderate to severe SDB (sensitivity 100%, NPV 100%). CONCLUSIONS: Nocturnal pulse oximetry has a high diagnostic accuracy in predicting moderate to severe SDB in patients with acute stroke. Oximetry can be a simple modality to rapidly recognize patients with more severe SDB and facilitate the referral to the confirmation sleep study.

Tips to Improve Success Rate of Intubation: A Standardized Rapid Sequence Intubation Protocol Attached to the Resuscitation Cart.

OBJECTIVES: The purpose of this study was to determine whether the implementation of a standardized rapid sequence intubation (RSI) protocol easily accessed on the resuscitation cart increased the success rate of intubation and reduced intubation-related complications in the emergency department (ED). METHODS: This work was a retrospective study of patients who were intubated in the ED between February 2006 and June 2007. The RSI protocol and a dosage cross-table were attached to the resuscitation cart beginning in January 2007. Intubated patients before and after application of the protocol were sorted into two groups: pre-intervention and post-intervention. RESULTS: A total of 147 patients were enrolled in the study, including 72 patients in the pre-intervention group and 75 patients in the post-intervention group. After application of the standardized protocol prompted on the resuscitation cart. The adherence rates to pre-treatment agents (69% vs. 90%; p < 0.01) and neuromuscular blocking agents (NMBA) (72% vs. 90%; p < 0.01) significantly improved. The first-attempt success rate was 57 of 72 (79%) in the pre-intervention group versus 70 of 75 (93%) in the post-intervention group (p = 0.016). The time to intubation did not differ signifi cantly, but the preintervention group had a higher percentage of prolonged time to intubation (13% vs. 3%; p = 0.029). The implementation of a standardized RSI protocol did not induce signifi cant adverse effects. CONCLUSIONS: Our study demonstrated implementation of a standardized RSI protocol, improved clinician adherence to the RSI, increased success of first-attempt ED intubation and led to a decline in the rate of prolonged time to intubation.

Curvature-correction-based time-domain CMOS smart temperature sensor with an inaccuracy of -0.8 °C-1.2 °C after one-point calibration from -40 °C to 120 °C.

This paper proposes a time-domain CMOS smart temperature sensor featuring on-chip curvature correction and one-point calibration support for thermal management systems. Time-domain inverter-based temperature sensors, which exhibit the advantages of low power and low cost, have been proposed for on-chip thermal monitoring. However, the curvature is large for the thermal transfer curve, which substantially affects the accuracy as the temperature range increases. Another problem is that the inverter is sensitive to process variations, resulting in difficulty for the sensors to achieve an acceptable accuracy for one-point calibration. To overcome these two problems, a temperature-dependent oscillator with curvature correction is proposed to increase the linearity of the oscillatory width, thereby resolving the drawback caused by a costly off-chip second-order master curve fitting. For one-point calibration support, an adjustable-gain time amplifier was adopted to eliminate the effect of process variations, with the assistance of a calibration circuit. The proposed circuit occupied a small area of 0.073 mm(2) and was fabricated in a TSMC CMOS 0.35-µm 2P4M digital process. The linearization of the oscillator and the effect cancellation of process variations enabled the sensor, which featured a fixed resolution of 0.049 °C/LSB, to achieve an optimal inaccuracy of -0.8 °C to 1.2 °C after one-point calibration of 12 test chips from -40 °C to 120 °C. The power consumption was 35 µW at a sample rate of 10 samples/s.